【Objective】 To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of skin injury around enterostomy. 【Methods】 The treatment process by PRP of 2 patients with skin injury around enterostomy was analyzed, and the PRP for each patient was tested with platelet count, bacteria and 5 growth factors. The clinical efficacy of enteral nutrition support therapy combined with allogeneic PRP was explored through analyzing treatment key points and literature review. 【Results】 After cleaning the skin around enterostomy, the patients were treated with PRP once daily for 5 days, adjusted to once every other day, and cure was achieved at 15 and 18 days, respectively. 【Conclusion】 Allogeneic PRP is a safe and effective treatment to promote skin injury around enterostomy regeneration in a short time, which can provide a new perspective for clinical.

Objective:To explore the effect of staged intervention based on the theory of planned behavior (TPB) on breastfeeding self-efficacy and exclusive breastfeeding among women with gestational diabetes mellitus (GDM) .Methods:From January to May 2019, continuous sampling was used to select 380 delivery women who were diagnosed with GDM in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University and met the inclusion and exclusion criteria as the research object. According to the random number table method, the delivery women were divided into the control group and the intervention group, 190 cases in each group. The delivery women in the control group received routine breastfeeding health education, while the delivery women in the intervention group implemented the TPB-based staged intervention on the basis of routine breastfeeding health education. The exclusive breastfeeding rate, knowledge and self-efficacy were compared between the two groups. As of four months postpartum, 169 delivery women were included in the intervention group and 157 delivery women in the control group.Results:The exclusive breastfeeding rate of delivery women in the intervention group at four months postpartum was 63.3% (107/169) , which was higher than that [47.1% (74/157) ] in the control group, with a statistically significant difference ( P<0.05) . The breastfeeding knowledge scores of the intervention group and the control group were (15.01±2.04) and (13.05±2.78) respectively, and the difference was statistically significant ( P<0.01) . The GDM breastfeeding knowledge scores were (8.86±1.85) and (4.80±2.76) , and the difference was statistically significant ( P<0.01) . There were significant differences in breastfeeding self-efficacy scores between the two groups at 38 to 40 weeks before delivery, three days, 42 days, and four months after delivery ( P<0.01) . There were significant differences in the exclusive breastfeeding rates between the two groups of GDM women at different time points ( P<0.05) . Conclusions:The staged intervention based on TPB can improve the effect of breastfeeding in GDM women, enhance maternal knowledge and self-efficacy, and increase the rate of exclusive breastfeeding.

The rapidly aging society gives rise to sizable demands for chronic disease nursing care. With IT development as backup, the hospital has developed a platform for regional collaborative nursing informationization within a medical alliance and a health management platform for home care of the elderlies. This practice can build an extended nursing care model, featuring the three main service lines of " hospital-family, hospital-medical alliance and hospital-community hospital-family". The model provides diversified, personalized, disease specific, informationization and multi-disciplinary coverage for nursing care, providing the primary level with high quality nursing resources.Medical alliances and corresponding communities share information, for a full-range, full region and full timeframe coverage of nursing health supervision and scientific guidance, thus effectively minimizing the rate of revisit to upper-level hospitals by patients and implementing the hierarchical medical system.

Objective To investigate the current situation of social support for patients with coronary heart disease intervention in different hospitals in Dalian, to analyze the influence of different demographic characteristics on patients' social support, to provide reference for the rehabilitation and management of patients undergoing coronary intervention surgery. Methods From November 15th to 16th, 2017, a cross-sectional unified investigation was carried out in 20 hospitals of different levels in Dalian, patients' general information questionnaire, Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Self-management Behavior Scale (SSRS) and Social Support Rating Scale (SSRS) were adopted. Results The total score of social support was 29.57 ± 12.01 in patients with coronary artery disease and interventional therapy in different hospitals in Dalian area. The scores of social support in patients with different residence area and residence condition were statistically significant (F=1.769, 6.150, P<0.01). The influencing factors of patients'social support were living condition, depression and self-management (r=-0.243,-0.129, 0.255, P<0.05). Conclusion Social support for patients with coronary artery disease intervention in different hospitals in Dalian is at a moderate level. And affected by living conditions, depression, self- management and other factors. Medical staff should formulate corresponding intervention measures to improve their social support level and improve the quality of life of patients.

OBJECTIVETo judge whether algesia sensitization of some acupoints is existed and whether the acupoint algesia sensitization area is expanded in the patients of intestinal cancer.

METHODSTotally, 30 patients of intestinal cancer and 30 healthy subjects were included. The electronic Von Fray was used to determine the pressure-pain thresholds at 13 acupoints relevant with gastrointestinal disorders and the reference points at the sites 1and 2lateral to those points as well as the sites at the corresponding nerve segments. Compared with the pressure-pain thresholds at the reference points of the different segments, the relative value was calculated. The changes were analyzed in the pressure-pain thresholds at the relevant acupoints on the body surface in the patients of intestinal cancer as compared with the relative pressure-pain thresholds in the healthy volunteers.

RESULTSThe pressure-pain thresholds at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11) and Dachangshu (BL 25) in the patients of intestinal cancer were all significantly reduced as compared with those of the healthy subjects (<0.05,<0.01,<0.001). At the non-acupoint sites 1and 2lateral to those acupoints as well as at the sites of the same segments, the pressure-pain thresholds were reduced significantly as compared with the control group (<0.05,<0.01,<0.001). Particularly, the sensitization zone of Yinlingquan (SP 9) focused on the acupoint, the site 1lateral to it as well as the non-acupoint sites of the same segments (<0.01,<0.001).

CONCLUSIONThe acupoint sensitization is displayed at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11), Dachangshu (BL 25) and Yinlingquan (SP 9) and the sensitization area is expended in the patients of intestinal cancer.

Objective To investigate the ultrasonic atomization anesthesia time guided needle aspiration biopsy for endobronchial ultrasound (EBUS-TBNA) effect of anesthesia in patients. Methods A total of 60 patients of EBUS-TBNA were divided into A group, B group and C group by random digits table method, each group of 20 cases. Three groups of patients were treated with topical anesthesia with 2%lidocaine aerosol inhalation, atomizing inhalation time:A group 20 min;B group 25 min;C group 30 min. Fiberoptic bronchoscopy was performed in accordance with operating procedures after anesthesia. The changes of vital signs were observed. The patients were investigated by questionnaire. Results A, B, C three groups of the highest blood pressure were (141.90±3.24), (132.30±3.06), (131.15±3.42) mmHg (1 mmHg=0.133 kPa), heart rate was (98.25 ± 3.39), (90.50 ± 3.85), (92.20 ± 5.12) beats/min, breath respectively was (20.45±1.43), (19.15±1.23), (19.00±1.38) beats/min, blood oxygen saturation was 0.9150± 0.0248, 0.9750±0.0128, 0.9735±0.0114, the B and C group was more stable than the A group (P<0.05), B, C two groups were not statistically significant (P>0.05). A, B, C three groups of patients with bronchoscopy insert a successful number of cases were 55%(11/20), 90%(18/20), 90%(18/20), A group was lower than B, C two group (χ2=6.144, P<0.05). The subjective comfort of the three groups were (28.40± 1.82), (37.10 ± 2.02), (36.15 ± 1.42)points, A group and B, C two groups were statistically significant (P<0.05), B, C two groups were not statistically significant (P>0.05). There was significant difference in the effect of anesthesia among three groups (Z=2.105, P<0.05). Conclusions Using 2%lidocaine ultrasonic atomization inhalation anesthesia for patients with local anesthesia, the effect of anesthesia is 25 min and the patient′s tolerance is the best.

Objective: To investigate the effect and mechanism of hydroxyfasudi (HF), a specific Rho kinase inhibitor, on lipopolysaccharide(LPS)induced endothelial dysfunction. Methods: A total of 24 male Sprague Dawley rats were randomly divided into control group(n=6), HF group(n=6), LPS group(n=6) and LPS + HF group(n=6) with random number table method. There was no special treatment in control group. HF (30 mg/kg) was injected intraperitoneally in HF group. LPS (1 mg/kg) were injected intravenously in LPS group. In LPS+ HF group, HF (30 mg/kg) was injected intraperitoneally, followed by intravenous LPS injection (1 mg/kg) 30 minutes later. All rats were sacrificed after 8 hours, and aortic tissue was extracted. RT-PCR was performed to detect mRNA levels of Rho-associated coiled-coil protein kinase (ROCK)1, connexin (Cx)43 and caveolin (Cav)1. The protein levers of ROCK1, Cx43 and Cav-1 were assessed by Western blot and immunohistochemical staining respectively. Results: (1) RT-PCR experiments showed that mRNA levels of ROCK1(2.67±0.03 vs. 1.00±0.04), Cx43(1.73±0.03 vs. 1.00±0.08), and Cav1(1.85±0.04 vs. 1.0±0.03) in LPS group were significantly higher than in control group(all P<0.05). mRNA levels of ROCK1(0.38±0.02), Cx43(0.58±0.02), and Cav1(0.27±0.01) in LPS + HF group were significantly lower than in LPS group(all P<0.05). (2)Western blot analysis showed that protein levels of ROCK1(3.46±0.82 vs. 2.19±0.56), Cx43(0.33±0.09 vs.0.11±0.06), and Cav1(3.45±0.74 vs. 2.25±0.91) in LPS group were significantly higher than in control group(all P<0.05). Protein levels of ROCK1(1.09±0.52), Cx43(0.01±0.06), and Cav1(2.06±0.40) in LPS + HF group were significantly lower than in LPS group(all P<0.05). (3) Immunohistochemical staining showed that protein levels of ROCK1(84.1±0.9比53.7±2.9), Cx43(99.1±2.1 vs. 46.2±0.8), and Cav1(167.0±6.4 vs. 84.9±1.0) in LPS group were significantly higher than in control group(all P<0.05). Protein levels of ROCK1(30.4±0.6), Cx43(21.4±1.3), and Cav1(55.8±2.8) in LPS + HF group were significantly lower than in LPS group(all P<0.05). Conclusion HF attenuates LPS induced endothelial dysfunction probably via suppressing the expression of ROCK1, Cx43 and Cav1.

Objective To compare the consistency of the results of clinical specimens between Tecan Freedom Evolyzer-2200 automated enzyme immunoassay analyzer and manual ELISA method,so as to explore more scientific and reliable test method.Methods Ninety samples were randomly selected from clinical and physical examination,the IMARK2 microplate reader and the instrument operating manual sample measurement was used to test hepatitis A,hepatitis B 5,hepatitis C,hepatitis E 2,TP and HIV,and the results were given correlation and linear regression analysis.Results For the test items of HBsAg,HBsAb,HBeAg,TP,HIV,the correlation coefficient was r2＞ 0.9,the data showed a good correlation,and for HAV-IgM,HBeAb,HBcAb,HCV,HEV-IgM,HEV-IgG,the correlation coefficient was 0.9＞ r 2 ＞ 0.6.Compared with manual method,the total coincidence rate of automated enzyme immunoassay analyzer was 96.9％ in 11 indexes of 90 samples.Conclusions Automatic and manual ELISA method has a good correlation.Automatic ELISA also greatly reduce the labor burden of laboratory personnel,improve efficiency,should be strengthened in clinical practice.

Objective To evaluate the expression of epidermal growth factor receptor ( EGFR ) mutation specific antibodies in invasive lung adenocarcinomas, and their sensitivity, specificity, as well as relationship to histological subtypes.Methods Immunostaining with EGFR mutation-specific antibodies, del E746-A750 in exon 19 and L858R in exon 21, was performed in tissue microarrays of 884 cases of resection specimens to study the relationship between the immunophenotypes and morphologic subtypes.The sensitivity and specificity of the stains were compared with gene mutations detected by amplified refractory mutation system-polymerase chain reaction ( ARMS-PCR).Results Of the 884 cases, the expression of del E746-A750 in exon 19 was 3+, 2+, 1+and 0 in 7 cases ( 0.79%) , 38 cases ( 4.30%) , 129 cases (14.59%) and 710 cases (80.32%), respectively.For L858R in exon 21, 3+, 2+, 1+and 0 staining were seen in 82 cases (9.28%), 93 cases (10.52%), 82 cases (9.28%) and 627 cases (70.93%), respectively.For both antibodies, positive expression (1+or more) was mainly observed in lepidic, acinar and papillary predominant subtypes, and rarely seen in solid subtype or invasive mucinous adenocarcinoma ( P=0.014 and 0.016).If 1+to 3+expression was set as positive, the specificity of exon 19/exon 21 reached 98.59%/92.98%, while the sensitivity was relatively lower ( 62.86%/88.89%).If 2+to 3+expression was read as positive, the specificity and sensitivity were 99.30%/97.37% and 25.71%/74.60%for exon 19/exon 21.If only 3+expression was considered positive, the specificity was 100.0%for both antibodies, with a low sensitivity (8.57%for exon 19 and 34.92%for exon 21).Of the 18 cases with E746-A750 del in exon 19 based on molecular detection, the sensitivity of immunohistochemistry for exon 19 was 88.89%if a positive cutoff value≥1+was used;in contrast, of the 8 cases harboring other deletions in exon 19, only two cases were positive as 1+.Conclusions Both the EGFR mutation specific antibodies del E746-A750 in exon 19 and L858R in exon 21 demonstrate high specificity and relatively low sensitivity, and are mostly expressed in lepidic, acinar and papillary predominant subtypes, but rarely in solid subtype or invasive mucinous adenocarcinoma.For cases with 3+expression, a mutational statue for EGFR is likely.For the 2 +positive cases, the accuracy to predict mutation almost reaches 90%, but molecular detection for confirmation is desirable.For the 1 +and negative cases, DNA-based test is essential to avoid false negativity.

Objective To establish a real‐time fluorescent polymerase chain reaction and detect 16S rRNA gene of Legionella strains isolated from sputum specimens of patients with pulmonary infection by using this method .Methods 16s rRNA gene of Le‐gionella was used to design primers and probes .The reaction system and reaction conditions were optimized and the specificity ,sen‐sitivity and repeatability of this method were verified by detecting Legionella pneumophila ,non‐Legionella pneumophila and other bacteria .A total of 557 sputum specimens of patients with pulmonary infection were detected ,and PCR‐digestion identification method was carried out as control .Otherwise ,sequences of 16S rRNA were verified in patients with positive detection results .Re‐sults The results showed that all reference strains of Legionella were positive ,while all of other bacteria were negative ,and the sensitivity was 102 CFU/mL .Among sputum specimens collected from 577 cases of patients with pulmonary infection ,the positive rate of Legionella detected by using real‐time fluorescent PCR and PCR‐digestion identification method was 23 .1% and 19 .9% re‐spectively ,while the positive rate was 17 .2% by verifying the sequences of 16s rRNA .There were no statistically significant differ‐ences of positive rate among the three methods(P>0 .05) .Conclusion The real‐time fluorescent PCR is fast and convenient in de‐tection of Legionella strains isolated from sputum specimens of patients ,which could be an assisted method for clinically diagnosing Legionella infection .