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Objective Study on 60 cases of advanced non-small cell lung cancer patients in the Apa imatinib mesylateadverse reactions after treatment , and to develop nursing methods for these adverse reactions. Methods Non-small cell lung cancer patients who were treated in our hospital from September 2015 to September 2016 were treated with Apa imatinib mesylate and observed the adverse reactions during the course of treatment. Results Adverse reactions occurred in 45 patients, and the incidence of adverse reactions was 75.00％.29 cases of patients with skin rash, 24 cases occurred in patients with hypertension, 30 cases of patients with diarrhea, nausea and vomiting occurred in 21 patients, 5 cases occurred in patients with proteinuria, 7 cases of patients with oral mucositis.Conclusion Non-small cell lung cancer patients had adverse reactions after treatment with Apa imatinib mesylate and nursing intervention can improve the quality of life of patients.
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Objective To investigate the safety and feasibility of totally laparoscopic radical resection of gallbladder cancer.Methods The retrospective cross-sectional descriptive study was adopted.The clinical data of 30 patients who underwent laparoscopic radical resection of gallbladder cancer at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2013 to August 2015 were collected.The patients received synchronous hepatic segmental or extrahepatic bile duct resection according to the conditions of patients,and choledochojejunostomy was applied to patients undergoing extrahepatic bile duct resection.The patients accepted postoperative adjuvant chemotherapy according to the results of postoperative pathological examination.Observation indicators included (1) operation situations,including surgical procedures,operation time,volume of intraoperative blood loss and number of lymph node dissected,(2) postoperative situations,including time for outoff-bed activity,time for diet intake,time of drainage tube removal,occurrence of complications and duration of hospital stay,(3) results of postoperative pathological examination,including tumor stage and surgical margin,(4) postoperative adjuvant treatment,(5) follow-up situation including the survival of patients,tumor recurrence and metastasis.The follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence and metastasis up to December 2015.Count data were represented as average (range).Results All the 30 patients underwent successful laparoscopic radical resection of gallbladder cancer combined with hepatic S4b and S5 resection + lymph node dissection at N1 region.Six patients with obstructive jaundice caused by tumor invaded to extrahepatic bile duct underwent combined laparoscopic extrahepatic bile duct resection + Roux-en-Y hepaticojejunostomy,without perioperative death.The average operation time,average volume of intraoperative blood loss and average number of intraoperative lymph node dissected were 238 minutes (range,178-430 minutes),250 mL (range,200-600 mL) and 7 (range,4-15),respectively.(2) The patients got out-off-bed activity and normal diet intake at postoperative day 2,with a average time of drainage tube removal of 3 days (range,0-25 days) and an average duration of hospital stay of 5 days (range,3-28 days).Two patients with complications were cured by symptomatic treatment.(3) Results of postoperative pathological examination showed that all the patients received R0 resection,and pathological stage showed that 12 patients were detected in Ⅰ B stage,10 in Ⅱ stage,7 in ⅢA stage and 1 in ⅢB stage.(4) One patient in Ⅲ B stage (pT3N1 M0 stage) received gemcitabine + cisplatin chemotherapy and other patients didn't receive the adjuvant treatment.(5) All the patients were followed up for a median time of 16 months (range,4-32 months),without tumor recurrence and metastasis at Trocar puncture site.There were 25 patients with tumor-free survival and 5 patiens died of tumor recurrence.Conclusion Laparoscopic radical resection of gallbladder cancer is technically safe and feasible,with a satisfactory short-term outcome.
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Obejective To reform the electrocardiogram teaching mode under clinical pathophisioligy and therapy(CPPT) mode.Methods The junior students of Grade 2010 in Second Clinical Medical College of Wuhan University were selected as subjects.The students were randomly divided into experimental group (44 students) and control group(52 students).Control group was taught by using traditional methods for electrocardiogram(ECG) diagnostics theory,and by using Diagnostics department's own Atlas,while experimental group was taught by reformed teaching methods,and ECG reformed textbook was used in their theoretical lessons,strengthening electrocardiogram and electrophysiology,cardiovascular disease combined.Meanwhile,the practice of teaching was taught by using preview-speaking Figure-Picture stories-Case-Read figure,a way to strengthen the theory-practice-theory of the cycle.The questionnaire was carried out in two groups after ECG teaching.After the end of the course two groups were given packet electrocardiogram atlas test and ECG theoretical knowledge examination and the above evaluation results were statistically analyzed by using SPSS 10.Results The statistically significant differences between experimental group and the control group were in the right ventricular hypertrophy,ventricular fibrillation,WPW syndrome,et al(P＜0.05).The ratio of the experimental group students' liking electrocardiogram course and their recognition of electrocardiogram teaching mode was higher than that of the control group while the ratio of their thinking ECG difficult was lower than that of the control group and the difference was statistically significant difference(P＜0.05).The excellent rate and good rate of the experimental group students' theory knowledge examination results were higher than the control group,two groups of results distribution difference being statistically significant(P=-0.043).Conclusions CPPT teaching model can effectively help students overcome the difficulties in reading electrocardiogram and deepen their understanding of theoretical knowledge and memory.
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Objective To explore the risk factors related to death in patients with acute myocardial infarction(AMI) in hospital,so as to guide clinical treatment to reduce the occurrence of death.Methods Two hundred and seventy cases with AMI who got in infarction within 24 h were studied in the Cardiology Departmentof Zhongnan Hospital of Wuhan University from Jan.2010 and Jun.2013.The patients were divided into the death group(n =32) and the cured group(n =232) according to the endpoint in hospital.The clinical information was recorded and multiple factors logistic regression analysis was applied to analyze the risk factors of death due to AMI.Results The age,serum creatinine(Cr) in both groups were ((65.21 ± 13.55) years old,(76.41 ±10.19) years old) and ((100.23 ±65.99) μmol/L,(139.22 ±92.03) μmol/L) and there were statistically significant differences (P ＜ 0.05).The differences of other indicators in two groups were no statistically significant.Clinical data comparison between the two groups showed that incidence rate of arrhythmia (14.7％),the disease rate of anterior descending coronary artery (50.4％),the disease rate of circumflex branch coronary artery (48.7％),the level of high sensitivity C reactionprotein (hs-CRP) ((5.92 ± 4.41) mg/L),brain natriuretic peptide (BNP) ((844.89 ± 1108.41) ng/L) and creatine kinase-MB (CK-MB) ((87.99 ± 140.45)U/L) in death group were lower than those in cured group (31.3％,81.3％,68.8％,(10.82 ± 2.29) mg/L,(1210.57 ± 984.44) ng/L,(161.86 ± 214.75) U/L; P ＜ 0.05).Multiple factors logistic regression analysis showed that elder age (OR =1.078,95 ％ CI:1.014-1.118,P =0.015),arrhythmia occurred or not in hospital (OR =1.636,95％ CI:1.151-3.041,P =0.024),the pathological changes of anterior descending coronary artery (OR =1.428,95 ％ CI:1.143-2.437,P =0.018),the level of hs-CRP (OR =1.352,95％ CI:1.137-1.607,P =0.001) were the independent risk factors for myocardial infarction patients' death.Conclusion Elder age,arrhythmia occurred in hospital,the pathological changes of anterior descending coronary artery,the high level of hs-CRP are the independent risk factors for AMI patients death.Relevant measures in the treatment should be taken to reduce their risk of death.
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We used adsorption method to immobilize the lipase by using nano-silica dioxide as the carrier. And we also studied different immobilization conditions effects on the catalytic activity. We got optimize immobilization conditions which were as follow the lipase quantity of 28,300 U/g, temperature of 45 degrees C, pH of 7.5 and treated for 10 h. Under these conditions the immobilized lipase activity yield 3867 U/g carrier. The best reactive temperature for immobilized lipase was 45 degrees C and higher than 5 degrees C for free enzyme, and the optimal pH dropped to 5.5 compared that of free enzyme (pH 7.0). The immobilized lipase stability for thermal and pH are improved than free lipase. When temperature was below 70 degrees C the immobilized enzyme activity was over 70% than initial activity. The free lipase activity just kept original 30% at 50 degrees C. When pH was 5-8, the immobilized lipase activity was still more than 50% and the free lipase only remained 20%. When we used the immobilized neutrophil lipase catalyzing different oil to produce biodiesel such as soybean oil, rapeseed oil and waste oil, the esterification rate of rapeseed oil was the highest.
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Enzyme Stability , Enzymes, Immobilized , Metabolism , Hydrogen-Ion Concentration , Lipase , Chemistry , Metabolism , Metal Nanoparticles , Chemistry , Silicon Dioxide , Chemistry , TemperatureABSTRACT
This article unscrambled the concept of pathogenesis theory,through textual research of literatures,directly explained the concept connotation.From the relationship between pathogenesis and symptom differentiation and the innovation of pathogenesis theory of doctors in past dynasties,it demonstrated the possibility that pathogenesis theory was the innovation breakthrough point of traditional Chinese medicine theory.It proposed the conjecture that pathogenesis was the "saddle point" "sensitive point" of traditional Chinese medicine is theory,and proposed several assume about pathogenesis theory study.
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Pathogenesis is the nucleus of diagnosis and treatment in TCM, this article has reviewed about the research on pathogenesis in TCM, summed up the research results, especially given the analysis on that. It proposes that deeper research would be done on defining the concept and connotation of pathogenesis, clarifying the relation between pathogenesis and syndrome differentiation, and establishing the core states about pathogenesis and so on.
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This article discussed the ancient and modern meaning of security of intense drugs for pregnant woman. And emphatically studied the meaning of the ‘gu’, pointing out that ‘gu’had three connotations, one referred to disease, second mean the original disease, with the ‘new’disease relative, the third referred to reasons. In addition, the article expounded how can be safe for the pregnant woman to use drugs with extremely intense action. In this paper, its purpose was to examine how to achieve security under circumstance of sick and fi nally achieve balance and harmony.
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All patients were treated with Zhong Yan No. 2 Prescription, 3 months constituting one course. Indexes of immunologic functions before and after treatment were compared and HIV -Rt - PCR detection was made in 16 cases. Results indicated that in absolute number of CD4, 8 cases increased, 14 cases decreased and 7 cases did not change; in CD4/CD8 ratio, 2 cases increased, one case decreased and 16 cases did not change; Two cases had increase of both CD4 and CD4/CD8 ratio: 4 cases had a decrease of new pterin, 11 cases increased and one case no change; 6 cases had a decrease of HIV - Rt - PCR, 8 cases increased and 2 cases no change. The total effective rate was 48.28% based on comprehensive assessment of virus, immunity, body weight and symptoms.