Objective To investigate the changes in the expression of cold-inducible RNA-binding protein (CIRBP) in a radiation-induced lung injury model. Methods Thirty male C57BL/6 mice were randomly divided by body weight into control group (no intervention) and model group (single chest X-ray irradiation with a dose of 20 Gy to build a radiation-induced lung injury model). The mice were dissected five weeks after irradiation. Hematoxylin-eosin staining and Masson staining were used to observe the pathological changes of the lung tissue and the deposition of collagen fibers. Immunohistochemistry was used to measure the expression of the inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the lung tissue. qRT-PCR was used to measure the expression of CIRBP mRNA in the lung tissue. The expression of CIRBP protein in the lung tissue was determined by the immunofluorescence assay and Western blot. Results Compared with the control group, the model group showed significant pulmonary vascular congestion, significant inflammatory cell infiltration, significant thickening of some alveolar septa, significantly increased IL-6 expression [(129.41 ± 5.58) vs (187.22 ± 34.77), t = 3.179, P < 0.05], significantly increased TNF-α expression [(137.52 ± 23.53) vs (187.02 ± 19.16), t = 5.069, P < 0.05], significantly increased CIRBP mRNA expression [(1 ± 0.08) vs (1.97 ± 0.39), t = 3.45, P < 0.05], and significantly increased CIRBP protein expression [(9.32 ± 1.26) vs (14.76 ± 1.61), t = 3.751, P < 0.05], by the immunofluorescence assay; [(1.13 ± 0.17) vs (1.49 ± 0.14), t = 2.819, P < 0.05], by Western blot). Conclusion The expression of CIRBP is significantly increased in the radiation-induced lung injury model, which may be an important pro-inflammatory factor in radiation-induced lung injury.

Objective:To summarize the midterm to long-term outcomes and experiences of endovascular treatment (ET) of spontaneous isolated superior mesenteric artery dissection (SISMAD).Methods:The clinical data of 31 SISMAD patients from Jan 2011 to Dec 2019 treated with ET was retrospectively analyzed.Results:Successful ET was achieved in 29 patients with a technical success rate of 93.5%. A total of 36 self-expandable bare stents were planted in 28 patients and plain old balloon angioplastry (POBA) was performed in 1 patient. Abdominal pain disappeared within 24 hours in 89.3% of the patients after stenting. The rate of perioperative complication was 3.2%. There was no SMA dissection rupture bleeding, nor perioperative death occurred. The mean follow-up time was 53.5 (range, 6 to 110) months. There was no dissecting aneurysm formation, no SMA rupture and bleeding, and no stent rupture during the follow-up. The post ET 1-year, 3-year, and 5-year free from reintervention rate were 100%, 100%, and 91.7%, respectively.Conclusions:ET for SISMAD is safe and effective with satisfactory perioperative and midterm to long-term outcomes.

Objective:To evaluate the imaging features of CT scan in patients with COVID-19.Methods:Clinical data of 56 patients with COVID-19 from January 17 to 19, 2020 admitted to Wenzhou Central Hospital and the Second Affiliated Hospital of Wenzhou Medical University were retrospectively reviewed. The clinical manifestations, lung imaging characteristics and treatment outcomes of patients with different severity were analyzed with SAS software.Results:Fever (92.8%, 52/56), dry cough (75.0%, 42/56) and asthenia (58.9%, 33/56) were the first symptoms in most of the patients; some patients also had shortness of breath (25.0%, 14/56) and pharyngeal pain (10.7%, 6/56). Chest high-resolution CT scan showed that in 42 moderate patients, ground glass-like high-density shadows in the lung were observed in 30 cases (71.4%) ; localized plaque consolidation shadows and bronchial inflation signs were observed in 10 cases (23.8%). In 12 severe patients, 11 had high-density patches involving multiple lung lobes (≥3). In 2 critically ill patients the patches and stripes involving the entire lung were observed; and cord-like high-density shadow, local consolidation and fibrosis were also shown.Conclusion:The multiple ground-glass changes outside the lungs are early imaging manifestations of COVID-19 patients. The increase in pulmonary lobe consolidation and fibrosis may indicate the disease progression, and the degree of lung consolidation and fibrosis is closely related to the disease severity.

Objective To evaluate the effects of the quality-improving program on reducing the bloodstream infection of preterm infants in NICU.The program included emphasizing hand hygiene,strictly controlling the use of antibiotics and following the extubation indications of peripherally inserted central catheter (PICC).Method From October 2016 to March 2017,preterm infants admitted to NICU after the implementation of quality improvement program were assigned into the intervention group,and the infants admitted from April 2016 to September 2016 without the program were in the control group.The x2 test and t test were used to analyse the effects of the program,the rate of bloodstream infection and related complications.Result A total of 432 cases were enrolled in this study.Among them,221 cases were in the intervention group and 211 cases the control group.The rate of hand hygiene in the intervention group was significantly higher and the duration of antibiotic use per 1 000 hospitalization days and the average days of retaining the PICC were significantly shorter than the control group (P ＜ 0.001).The incidence of bloodstream infection in the intervention group was lower than the control group (5.9％ vs.11.4％,P =0.047),and the duration of non-invasive ventilation,parenteral nutrition,average hospitalization days,and the incidence of stage 11 and above necrotizing enterocolitis were lower than the control group (P ＜ 0.05).Conclusion The evidence-based quality improvement program has positive effects on reducing the bloodstream infections and related complications of preterm infants in NICU.

Objective: To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation. Method: The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR₂) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR₂ rate was analyzed. Results: 68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR₂. All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR₂ compared with non-KIT D816 group (23.1% vs 57.1%, χ²=7.559, P=0.006), and patients with longer CR₁ duration achieved significantly higher CR₂ than those with CR₁ duration less than 12 months (74.1% vs 31.9%, χ²=9.192, P=0.002). KIT D816 mutation was tightly related to shorter CR₁ duration. No significant difference of 2 years post relapse survival was observed between KIT D816 mutation and non-KIT D816 mutation group. Conclusion KIT D816 mutation at diagnosis was an adverse factor on the salvage therapy in relapsed AML with t(8;21) translocation, significantly related to shorter CR1 duration, and can be used for prediction of salvage therapy response. KIT D816 mutation could guide the decision-making of salvage therapy in relapsed AML with t(8;21) translocation.

The stage of impaired glucose regulation is a necessary stage in the development of diabetes.Nearly a quarter of patients without diabetes intervention develop into diabetes within four to seven years without intervention.Therefore,the intervention of pre-diabetes treatment in the prevention and control of diabetes is of great significance.This study was to investigate the effect of Tangnaikang granule at the early stage of type 2 diabetes mellitus.The age,course of disease,sex,symptom score of TCM were recorded,so were the blood lipid,blood glucose,liver and kidney function,electrocardiogram were recorded.Under the condition of low sugar and low salt diet and healthy exercise,the patients were divided into the control group (n--31) and the treatment group (n=43).The patients in the double-blind control group were treated with Kangnaikang granule and Tangnaikang granule to treat 74 patients with type 2 diabetes mellitus three months.Three months after the detection of fasting and postprandial blood glucose,glycosylated hemoglobin,glucose tolerance,insulin tolerance and other indicators to examine the efficacy of both.Tangnaikang granules were superior to placebo in terms of effective rate of treatment,TCM symptom score and blood sugar recovery rate,and taking Tangnaikang granule without liver and kidney function and other injuries.Tangnaikang is safe and effective for pre-diabetes patients.

Objective To investigate the effects and the mechanism of sorafenib on hepatocellular car-cinoma growth and vasculogenic mimicry (VM)in mice.Methods A subcutaneous implantation mouse model of human hepatocellular carcinoma (HCC)HepG2 cells were established.Mice inoculated with HepG2 cells were randomly divided into the treatment group (sorafenib 30 mg·kg -1 ·d -1 )and the control group by using of paired comparison method.Growth of established tumor xenografts was monitored at least twice weekly by vernier caliper measurements.VMwas assessed by immunohistochemical assay and periodic acid schiff reaction (PAS)histochemical double-staining.The expressions of HIF-1 α,VEGFA,VEGFR-1 and MMP-2 in tumor tissues were also assessed by immunohistochemical assay,Western blotting and real-time quantitative PCR. Results The tumor volume in the sorafenib group was obviously decreased compared with the control group (809.69 mm3 ±208.71 mm3 vs 1 678.00 mm3 ±31 3.29 mm3 ),with a statistically significant difference (t =6.1 03,P =0.030).Haematoxylin and eosin (HE)staining showed that tumor tissues treated with sorafenib were characterized by obvious necrosis,but there were not the same cases in the control group.Sorafenib group significantly reduced the number of tumor functional vessel in HepG2 xenografts compared with the control group,as assessed by tumor vasculature uptake of DiOC7 (4.77 ±0.1 5 vs 8.44 ±0.68,t =9.1 92,P =0.01 3).The number of VMwas significantly decreased by sorafenib (1 .04 ±0.46 vs 2.66 ±0.42,t =4.51 0, P =0.041 ).Relative to controls,CD31 -positive vessels decreased after treatments (3.42 ±0.1 0 vs 1 .26 ± 0.1 4),with a statistically significant difference (t =21 .580,P =0.002).Compared with the control group, the protein levels of HIF-1 α(0.65 ±0.03 vs 1 .00 ±0.00),VEGFA (0.51 ±0.02 vs 1 .00 ±0.00), VEGFR-1 (0.45 ±0.04 vs 1 .00 ±0.00)and MMP-2 (0.69 ±0.02 vs 1 .00 ±0.00)were significantly decreased in the sorafenib group (t =1 9.650,P =0.003;t =40.493,P =0.000;t =23.429,P =0.002;t =26.071 ,P =0.002).Compared with the control group,the mRNA levels of HIF-1 α(0.78 ±0.05 vs 1 .00 ±0.00),VEGFA (0.52 ±0.05 vs 1 .00 ±0.00),VEGFR-1 (0.45 ±0.02 vs 1 .00 ±0.00)and MMP-2 (0.71 ±0.02 vs 1 .00 ±0.00)were also significantly decreased in sorafenib group (t =6.840,P =0.021 ;t =27.71 0,P =0.001 ;t =62.740,P =0.000;t =23.850,P =0.002).Conclusion Sorafenib can inhibit the tumor growth and VMchannels formation,which may be related with the HIF-1 αand VEGFA /VEGFR-1 signa-ling pathway.

Objective To observe the effect of percutaneous pulsedmagnetic stimulation of the preganglionic parasympathetic nervous system of spinal at T 12-L1 vertebral level (2-4 sacral spinal cord), in order to promote gastrointestinal peristalsis paraplegics and relieve symptoms of constipation .Methods Totals of 52 patients were divided into two groups by their admission date .The control group were applied the routine nursing care, including the psychology nursing care , drug intervention, diet, water balance, lower abdominal massage therapy, enema, pelvic floor muscle training and hyperbaric oxygen therapy .Based on the routine care, the intervention group was given the early percutaneous spinal cord pulsed magnetic stimulation of the preganglionic parasympathetic nerves of the spine at T 12 -L1 vertebral level ( 2 -4 sacral spinal cord ) . Results In the intervention group , 1 patient had cervical fracture and dislocation;2 patients had tumor invasion of the primary caudaequina of spinal cord.88.46%(23/26) patients had regular bowel movements.In the control group, only 61.54% (16/26) patients had regular bowel movements.The difference was statistically significant (χ2 =5.026,P<0.05).The effective rate of the intervention group was 76.9%(20/26), which was significantly higher than 50.0% (13/26) in the control group (χ2 =4.046,P<0.05).Conclusions Percutaneous pulsed magnetic stimulation of the parasympathetic preganglionic nerve can improve the recovery of neurological function and provide a simple , noninvasive and painless method to reduce the constipation and improve patients ’ quality of life.

Objective To summarize the nursing management of 125 I radioactive seed in the treatment of spinal metastases .Methods Fourteen patients with 125 I radioactive seed in the treatment of spinal metastases received the nursing intervention including psychological care , observation of disease after surgery , protection from radiation and nursing of complications .Results Nine patients received the percutaneous kyphoplasty combined with 125 I radioactive seed , and 5 patients received the dissection of tumors , laminectomy decompression , pedicle screw fixation and 125 I radioactive seed implantation .The displacement of particles and radioactive spinal cord inflammation were found in all patients .The cases of death were 0 cases during perioperative period .The volume of tumor was significantly reduced in 13 patients through the observation of CT, and was no changes in one patient .Conclusions 125 I radioactive seed in the treatment of spinal metastases is a new way to treat the tumor , and nursing intervention plays important roles of controlling the disease , improving the quality of life and prognosis of patients .

Objective Through the community health management of hypertension , to determine the input and output , change the knowledge , attitude, practice ( KAP) of hypertension patients and put forward the reasonable suggestions of antihypertensive treatment in order to reduce hypertensive patients 'medical expenses . Methods By random cluster sampling method , we selected 809 hypertension patients , over 18 years old, from two communities in Urumqi .414 patients were in the management group and 395 patients were in the control group.The health management the cost benefit was analyzed by the change of patient 's KAP, medical expenses and so on.Results For the knowledge and behavior changes , 17.94% patients in the management group and 3.04%patients in the control knew the classification of blood pressure (Z=-5.688,P=0.000).The master of normal range of blood pressure (Z=-11.927,P=0.000), knowledge of obesity (χ2 =15.608,P=0.000) and knowledge of risk factors (χ2 =-17.677,P=0.000) between groups had significant differences (P<0.01).The total drug expenses of the management group and the control group were (1 583.88 ±981.24) and (1 923.90 ±1 523.81) yuan, respectively;the total hospitalization expenses of the management group and the control group were (10 725.77 ±11 688.26) and (15 327.03 ±10 280.42) yuan, respectively, the differences were significant (t=2.14,2.75, respectively;P<0.05).The costs of patients taking the drug and other costs in the management group were lower than the control group , the differences were significant ( P <0.01 ). Conclusions Hypertension health management can obtain a good cost benefit , reduce hypertension sickness cost, and improve quality of life .