Objective To investigate the treatment of neonatal respiratory distress syndrome by less invasive surfactant administration(LISA)clinical efficacy,complications and influence on blood gas analysis.Methods A total of 100 cases of neonatal respiratory distress syndrome requiring pulmonary surfactant(PS)tracheal injection therapy and admitted to the Jinhua Central Hospital between December 1st 2019 and August 1st 2022 were randomly assigned into treatment group(50 cases)and control group(50 cases).The treatment group of children received PS treatment using LISA technology,while the control group of children received PS treatment using tracheal intubation tracheal instillation PS extubation followed by intubation-surfactant-extubation technology.The clinical treatment effect,blood gas analysis,non-invasive ventilation time,length of hospitalization,and incidence of complications were compared between the two groups.Results The total effective rate of treatment in the treatment group was higher than that in the control group;After 1 hour of PS treatment,the oxygen partial pressure and blood oxygen saturation of the treatment group were higher than those of the control group,while the carbon dioxide partial pressure was lower than that of the control group.The non-invasive assisted ventilation time of the treatment group was shorter than that of the control group.The incidence of bronchopulmonary dysplasia was lower than that of the control group.Their difference were statistically significant(P<0.05).Conclusion The use of LISA technology for PS treatment of NRDS can improve blood gas indicators,shorten non-invasive ventilation time,improve diagnostic and therapeutic effects,reduce the risk of bronchopulmonary dysplasia,and do not increase the incidence of complications such as tracheal mucosal injury and pulmonary hemorrhage in children.

Objective:To explore the effects of WeChat-based CT enhanced examination process on the examination efficiency of patients undergoing CT enhanced examination.Methods:Totally 178 patients who received CT enhanced examination in the Department of Radiology (Intervention) , China-Japan Union Hospital of Jilin University from January 2019 to December 2020 were selected by random sampling, of which 87 patients from January to December 2019 were included in the control group, while 91 patients from January to December 2020 were included in the observation group. Patients in the control group were subjected to routine procedures, while patients in the observation group were subjected to WeChat-based enhanced CT examination procedures. The Patient Satisfaction Questionnaire Short Form (PSQ-18) and China Occupational Strain Scale (COSS) were used to investigate the patients and compare the CT-enhanced examination efficiency, patient satisfaction and occupational tension of medical staff between the two groups. Totally 12 medical staff who worked in the Department of Radiation (Intervention) of China-Japan Union Hospital of Jilin University from January 2019 to December 2020 were selected by random sampling to investigate the impact of process optimization on the working conditions of medical staff. A total of 12 questionnaires were distributed to medical staff in this study, and 12 valid questionnaires were recovered, with an effective recovery rate of 100.00%.Results:The appointment time, waiting time, preparation time before examination and total examination time of the observation group were all shorter than those of the control group, and the difference was statistically significant ( P<0.01) . In addition, the PSQ-18 scores and total scores of patients in the observation group were higher than those in the control group, except for interpersonal communication skills of the follow-up personnel and the communication level of the follow-up personnel, and the difference was statistically significant ( P<0.05) . The COSS scores and total scores of medical staff in the observation group were lower than those in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The WeChat-based CT enhanced examination process can help improve the inspection efficiency among patients undergoing CT enhanced examination, improve patient satisfaction, and reduce the occupational tension of medical staff.

Objective:To explore the effect of health education based on action research theory and swallowing rehabilitation nursing for stroke patients with dysphagia.Methods:The random sampling method was used to select 128 stroke patients with dysphagia who were admitted to China-Japan Union Hospital of Jilin University from November 2020 to November 2021. According to the random number table method, they were divided into the control group and the experimental group. The control group received swallowing rehabilitation nursing, while the experimental group received action research theory health education on the basis of the control group. The swallowing function, self-care ability and quality of life were compared between the two groups.Results:Before nursing, there was no statistically significant difference in scores of Standardized Swallowing Assessment (SSA) , Exercise of Self-Care Agency (ESCA) and Swallowing-Quality of Life (SWAL-QOL) between the two groups ( P>0.05) . After 3 months of nursing, the SSA score of the two groups was lower than that before nursing, and the experimental group was lower than that of the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of ESCA scale in the two groups were higher than those before nursing and the experimental group were higher than the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of SWAL-QOL scale in the two groups were higher than those before nursing, and the experimental group were higher than the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of action research theory health education combined with swallowing rehabilitation nursing in stroke patients with dysphagia can improve the swallowing function of patients, self-care ability and quality of life.

Objective:To compare the differences in the delineation of the gross tumor volume (GTV) and lymph nodes of nasopharyngeal carcinoma (NPC) patients using computerized tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT), and to investigate the optimal standard uptake value (SUV; relative to the MRI-based delineation) for the automatic delineation of GTV using PET. Methods:A total of 53 NPC patients proposing to receive radiotherapy were selected for this study. The CT, MRI, and PET images of each patient were obtained before radiotherapy. Then GTV and positive lymph nodes were delineated on these three types of images. They were individually named GTV MRI, GTV CT, GTV PET2.5 (SUV=2.5), Lymph MRI, Lymph CT, and Lymph PET2.5 and compared. The GTV ∩2.5 (overlapped GTV) was obtained through the alignment of MRI and PET/CT images. Meanwhile, GTV was delineated on PET images using thresholds of SUV=4.0, 4.5, 5.0, and 5.6, obtaining GTV PET4.0, GTV PET4.5, GTV PET5.0, and GTV PET5.6. Then their volume and Dice similarity coefficients (DSCs) were compared. Results:Compared to GTV MRI, GTV CT decreased by 1.73% ( P>0.05) and GTV PET2.5 increased by 21.34% ( t=-3.52, P < 0.05) in the three types of images. The volume of Lymph PET2.5 was 1.61 and 1.87 times the volume of Lymph MRI and Lymph CT, respectively ( t=-4.12, -5.18; P< 0.05). The volume of high-SUV lymph nodes was 4.07 times the volume of lymph nodes with low SUVs or SUV=0 ( t=5.50, P< 0.05) on PET images. The DSC between GTV PET4.0and GTV MRI was 0.78 ± 0.27, which was lower than that between GTV PET2.5 and GTV MRI (0.84 ± 0.18). However, GTV PET4.0 approximated to GTV ∩2.5 ( P>0.05). Conclusions:Compared to CT and 18F-FDG PET/CT, MRI shows more accurate boundaries of GTV and lymph nodes. When 18F-FDG PET/CT was adopted to automatically delineate GTV, the GTV delineated using SUV=4.0 was closer to GTV MRI.

Objective: To explore the genes that may be regulated by cell division cycle 25A (CDC25A) with gene chip technology, and to elucidate and verify that CDC25A has a regulatory effect on the expression of liver cancer related genes. Methods: CDC25A expression in human liver cancer HepG2 cells was silenced by siRNA interference technology and a nude mouse xenograft model of liver cancer was successfully constructed in our previous research. Affymetrix human gene expression profiling microarray was used to further screen differentially expressed genes (DEGs) after silencing CDC25A in liver cancer xenografts, and GO analysis and KEGG analysis were performed. Some of the DEGs were verified by qPCR. Results: The chip screened 188 DEGs in liver cancer xenograft tissues after CDC25A silence, including 78 up-regulated genes and 110 down-regulated genes. These DEGs mainly involved in cell proliferation, apoptosis, protein complex binding, extracellular space, etc., and associated with the changes in pathways such as focal adhesions and extracellular matrix (ECM) receptor interactions. qPCR showed that the expression of HIPK2 mRNA was up-regulated and the mRNA expressions of (microfibrillar-associated protein 5(MFAP5) and cyclin D1 (CCND1) were down-regulated, which were consistent with the results of microarray detection. Conclusion: Using human gene expression profiling chip, the DEGs in liver cancer xenograft tissues in nude mice after silencing CDC25Awere successfully screened, providing effective clues for exploring the effect of CDC25Aon the growth of liver cancer.

Objective:To compare the effect of the 2% chlorhexidinegluconate disinfectant and 0.5% iodophor disinfectant on the maintenance of central venous catheter (CVC) in patients with immunodeficiency.Methods:The patients were randomly divided into two groups. 2% chlorhexidinegluconate disinfectant was used in the experimental group, and 0.5% iodophor disinfectant was used in the control group. The CVC was sterilized once a week and continuously maintained for 3 weeks. According to the condition of catheter, the dressing was changed in time in case of any problem,and the reason and time for the catheter nursing care were recorded. The duration of changing the catheter dressing in different disinfectant, incidence rate of dressings looseness and incidence of catheter-related infections in two groups were analyzed.Results:The duration of skin drying and duration of caring in the experimental group were (0.62±0.10)min, (11.67±0.33) min, significantly shorter than the control group [(1.97±0.18) min, (14.48±0.33) min]( t values were 63.044, 57.296, P<0.01).In term of the adverse effects on CVC,there were no statistical differences between two groups ( P> 0.05). Conclusions:Both 2% chlorhexidinegluconate and 0.5% iodophor disinfectant have similar disinfection effect on CVC caring, but 2% chlorhexidinegluconate disinfection is more efficient and worthy of application in clinical settings.

Objective To construct rat lysine-specific histone demethylase 1 (LSD1) overexpression plasmids and LSD 1 demethylation fragment disfunction plasmids,and to evaluate their expression levels in HEK293T cells.Methods LSD1 fragments were amplified by PCR,and LSD1 demethylation disfunction fragments were amplified by overlap PCR.Rat-specific LSD1 overexpression plasmids and LSD1 demethylation disfunction plasmids were constructed and verified by agarose gel electrophoresis and sequencing.HEK293T cells were infected using the validated recombinant plasmids and blank vectors,and the stably expressed cells were selected by puromycin.The expression of LSD1 in the stably expressed HEK293T was detected by Western Blot and real-time quantitative PCR.Results The results of agarose gel electrophoresis and sequencing showed that LSD1 overexpression plasmids and LSD1 demethylation disfunction plasmids were successfully constructed.The Western Blot and real-time quantitative PCR results showed that compared with the blank group,the relative expression of LSD1 and mRNA in the LSD1 overexpression group and the LSD1 demethylation disfunction group were up-regulated,and the differences were statistically significant(all P＜0.01).Conclusions The constructed LSD1 overexpression plasmids and LSD1 demethylationi disfunction plasmids can achieve overexpression of LSD1 gene in HEK293T cells.This paper lays a foundation for further study of the relationship between LSD 1 gene and related diseases and demethylation of LSD 1.

Objective To evaluate the treatment outcomes and toxicities of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for children and adolescents with nasopharyngeal carcinoma.Methods Forty-three nasopharyngeal carcinoma patients less than 19 years old were recruited between April 2010 and April 2016.All patients were treated with IMRT (total dose 61.2-76 Gy) combined with cisplatin based chemotherapy.The Kaplan-Meier test was used to calculate overall survival (OS) and progression-free survival (PFS).The patient's clinical characteristics,side effects and longterm effects of treatment were retrospectively analyzed.Results Among 43 patients,there were 29 (67.4％) male and 14 (32.6％) female,and the median age was 14 years old (range,6-18 years).According to AJCC 7thstaging system,2 patients were in stage Ⅱ,26 in stage Ⅲ,7 in stage ⅣA and 8 in stage Ⅳ B.All patients were confirmed as non-keratinizing carcinoma.The positive rates of EB virus VCAIgA was 53.8％ (7/13),and Rta-IgG was 60.0％ (6/10) before treatment.The median radiation dose was 70 Gy (range,61.2-76 Gy) to the primary tumor.Thirty-three (76.7％) patients received neoadjuvant chemotherapy,with 20 (46.5％) and 36 (83.7％) patients treated by concurrent and adjuvant chemotherapy,respectively.With a median follow-up of 24 months (range,3-76 months),the 5-year OS and PFS ratios were 75.3％ and 64.7％,respectively.There were 5 patients (11.6％) occurred to bone metastasis within 2 years after treatment.Hypothyroidism was reported in 47.4％ (9/19) patients after IMRT.Conclusions Nasopharyngeal carcinoma in childhood and adolescence is mostly locally advanced diseases with poor differentiation.IMRT combined with chemotherapy produce a well treatment outcome with good tolerance in children and adolescents patients.The most common treatment failure bone metastasis.Radiation-induced hypothyroidism is common.

Objective To investigate the effects of human milk fortifier on premature infant's cardiac function.Methods From January 2014 to December 2016, sixty premature infants of paediatric preterm infants were selected from Daqing Longnan Hospital,Heilongjiang province. The random number table method was divided into 30 cases (milk feeding and strengthening agent) and the control group of 30 cases (pure milk feeding).The heart rate of premature infant was measured before, during and after using human milk fortifier. After using human mike fortifier for 1 week, heart rate, electrocardiogram (p-wave duration, QRS wave duration, P-R interval, incidence of arrhythmia), echocardiogram (LVEF, RVEF, E/A ratio of mitral and tricuspid valves) and myocardial enzymes (the quantity of AST, LDH, CK and CK-MB) were compared between experimental group and control group.Results The heart rate of premature infant during using human milk fortifier was significantly faster than those before and after using human milk fortifier and that of children in the control group (P<0.05). There were no statistically significant differences in electrocardiogram (p-wave duration, QRS wave duration, P-R interval), the systolic and diastolic function of the heart and myocardial enzymes between the experimental and control groups (P>0.05).Conclusions Human milk fortifier can increase the heart rate of premature infant, and has no harmful effect on cardiac electrical activity, pump function and myocardial enzymes.

The authors firstly analyzed the integrating point of the 6S management thoughts and the demand of hospital management , as well as the specificity of hospital management in theory .Then summarized the practical experience in the process of the implementation of 6 S management , and sorted out the main problems .At last , this paper tried to give its solutions in terms of cultural concept , ethical construction , support system and information platform so as to enhance connotation of hospital culture and the level of fine management .