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The Clinical Significance of the Contents of CD44v5 in Peripheral Blood of Patients with Gastric Cancer

ObjectiveTo study the contents of CD44 that shared exon variant 5 (CD44v5) in peripheral blood lymphocytes (PBL) of patients with gastric carcinoma and the expression of CD44v5 in tumor tissue and their clinical significance. MethodsThe contents of CD44v5 were determined by FlowCytometry in PBL of 31 patients with gastric carcinoma before surgery and 10 normal controls. Tissue expression of CD44v5 in 33 patients with gastric carcinoma was investigated by immunohistochemistry. ResultsThe contents of CD44v5 were significantly higher in PBL of patients with gastric carcinoma before surgery than those of controls (P＜0.01). Nodepositive gastric cancer patients showed significantly elevated contents of CD44v5 in PBL in comparison with nodenegative gastric cancer (P＜0.01）. Significant correlations were noted between the contents of CD44v5 in PBL of patients with gastric carcinoma before surgery and tumor size, depth of invasion, lymph node metastasis and different the Vnion International Centre Le Cancer (VICC) stages of tumor (P＜0.05). The expression of CD44v5 could be detected in 69.7% of tumor tissue,but was not detected in adjacent normal gastric mucosa. Significant correlations were noted between CD44v5 expression and depth of invasion,and lymph node metastasis.The presence of CD44v5 protein was correlated with the lymph node involvement rate. Conclusion CD44v5 in PBL or tumor tissue may be useful as a metastatic marker. It may be of important clinical value in the diagnosis of metastasis and judgement of development for the patients with gastric cancer.

超选眼动脉插管溶栓治疗视网膜中央动脉阻塞一例

特定电磁波照射对预防老年患者经外周静脉置入中心静脉导管后机械性静脉炎的效果

目的　观察使用特定电磁波（TDP）照射对预防老年患者经外周静脉置入中心静脉导管（PICC）后机械性静脉炎的效果。 方法　2010年1月－12月将120例行PICC的肿瘤科老年患者根据登记号分为观察组和对照组，每组60例。对照组进行PICC常规护理；观察组在PICC常规护理基础上于置管24 h后加用TDP治疗，2次/d，20～30 min/次，连续使用7 d。观察两组机械性静脉炎的发生情况。 结果　观察组机械性静脉炎发生率8.33%，对照组23.33%，差异有统计学意义（P＜0.001）。 结论　应用TDP能有效预防和减少PICC所致机械性静脉炎的发生。

Research progress in the diagnosis and treatment of peripheral exudative hemorrhagic choroidal retinopathy

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a peripheral retinal disease characterized by subretinal hemorrhage and/or subretinal pigment epithelial hemorrhage or exudation. It is often misdiagnosed as age-related macular degeneration, polypoidal chorioretinopathy or choroidal melanoma. With the development of multimodal imaging, PEHCR has different features under different examinations, such as B-scan ultrasound, fluorescein fundus angiography, optical coherence tomography and so on, which contributes to differention from other diseases. Clinical treatments for the disease include intravitreal injection of retinal photocoagulation therapy, anti-vascular endothelial growth factor, pars plana vitrectomyand so on, but there is still no universal consensus. In order to gain a deeper understanding of the clinical features, treatment options and prognosis of PEHCR, minimize missed diagnoses and misdiagnoses, and improve treatment efficiency, further research is required.

EXPRESSION OF INTERLEUKIN-2 mRNA IN PERIPHERAL BLOOD LYMPHOCYTE PRE-AND POST-OPERATIVE OF GASTRIC CANCER PATIENT

Effect of radical operation on expression of interleukin-2(IL-2)mRNA and production of IL-2 were markedly reduced preoperatively and four weeks after operation,expression of IL-2 mRNA significantly enhanced,but it was still lower than that in the normal group.Production of IL-2 nearly reached normal level,When PBL was activated by phytohemagglutinin(PHA),expresseion of IL-2 mRNA and production of IL-2 were much higher than that in non-activated PBL.These results suggested that expression of IL-2 were much higher than that in non-activated PBL.These results suggested that expression of IL-2 mRNA and production of IL-2 are dificient in gastric cancer patients,and radical surgery will help them to recover and they can also be improved through activation with PHA.

Investigation on Knowledge of Peripheral Inserted Central Venous Catheter in Oncology Medical Staff Members of Class-Ⅲ Hospitals in Chengdu City

目的　了解成都市肿瘤科医护人员经外周静脉留置中心静脉导管术（PICC）认知现状，为今后开展PICC相关知识培训提供科学依据。 方法　2009年12月－2010年1月采用自行设计的问卷对成都市5家三甲医院的肿瘤科医护人员309名（医生134名，护士175名）进行PICC认知态度现状调查。 结果　成都市三甲医院肿瘤科医护人员PICC认知呈中等偏低的水平，护士PICC知识的掌握高于医生（P＜0.05），护士PICC态度得分优于医生（P＜0.05）。94.84%的医护人员知道PICC技术；只有8.38%的肿瘤科医护人员接受过PICC专业培训。不同文化程度、年龄、工龄、职业与PICC认知之间的差异存在统计学意义（P＜0.05）。 结论　三甲医院肿瘤科医护人员对PICC技术有一定的了解，但总体认知仍有待提高，需加强PICC相关知识培训，进一步提高医护人员PICC认知水平，以利于肿瘤专科开展PICC技术，促进肿瘤护理的专业化发展。

Application of transradial approach in peripheral interventional therapy

With the development of interventional therapy technology, trans radial access (TRA) has gradually become the main approach of interventional therapy. Compared with trans femoral access (TFA), TRA has obvious advantages, which can shorten the time of lying in bed and reduce the incidence of complications. However, the radial artery is thinner than the femoral artery, the incidence of spasm is high, and the success rate of puncture is low, so the technical level of operation is required to be high. Nowadays, TRA has been gradually applied to lung cancer, aortic disease, hepatocellular carcinoma, spleen disease, renal artery disease, and other peripheral vascular diseases. With the confirmation of the safety and feasibility of TRA in interventional therapy in different fields, the popularization of TRA in different interventional fields will be supported.

超声技术联合经外周静脉置入中心静脉导管支撑导丝头端退出法在导管多次异位颈内静脉复位中的应用

目的探讨经外周静脉置入中心静脉导管（PICC）置管时导管头端多次异位到颈内静脉时的有效复位方法。 方法收集2014年3月－12月在血管超声引导下行PICC置管时，导管头端异位到颈内静脉3次以上的患者17例，对其首先按常规复位法复位3次，仍不能成功复位，则采用支撑导丝头端退出法，以利用血液流向和重力作用，将异位的导管调整至正常位置。 结果17例患者先采用常规复位法复位3次，均不成功。改用支撑导丝头端退出法进行复位，一次复位成功16例，成功率为94.11%；二次复位成功率达100%。 结论PICC置管联合血管超声，能及时发现导管是否异位颈内静脉，采用常规复位方法3次，均不能成功复位时，采用支撑导丝头端退出法，可有效纠正导管头端异位，提高置管成功率，减少反复送管所致静脉并发症。

Clinical application of cone beam CT guided technique in diagnosis of pulmonary nodules

ObjectiveTo explore the clinical application of the comprehensive guidance technologies, such as cone beam computed tomography (CBCT), virtual bronchoscopic navigation (VBN), and superimposed high-frequency jet ventilator for respiratory control in the biopsy of peripheral pulmonary nodules (PPNs). MethodsThe clinical information of 3 patients with PPNs diagnosed by CBCT combined with VBN and superimposed high frequency superposition jet ventilator in Shanghai Changhai Hospital were retrospectively analyzed. Results Clinical data of 3 patients were collected. The average diameter of PPNs was (25.3±0.3) mm with various locations in left and right lung. The first nodule was located in the apex of the left upper lung, and the biopsy was benign without malignant cells. The lesion was not enlarged during the 5-year follow-up. The second one was located in the left lingual lung, and the postoperative pathology was confirmed as mucosa-associated lymphoma. The third one was located in the anterior segment of the right upper lung. After the failure of endobronchial procedure, percutaneous PPNs biopsy under CBCT combined with VBN was performed, and the pathological diagnosis was confirmed as primary lung adenocarcinoma. Postoperative pneumothorax complication occurred in the third patient with right lung compression rate approximately 20%. ConclusionsThe application of CBCT, combined with VBN and the superimposed high frequency jet ventilator for respiratory control can potentially improve the accuracy and safety in the diagnosis of PPNs. Multi-center clinical trials are needed to verify its further clinical application.

化学疗法经外周静脉置入中心静脉导管路径医护一体化管理模式探讨

【摘要】　目的　总结肿瘤患者化学疗法经外周静脉置入中心静脉导管（peripherally inserted central catheter， PICC）路径医护一体化管理模式的经验与效果，提高医护团队的工作效率。　方法　针对化学疗法PICC路径管理前医护合作存在的问题，通过优化配置医护团队，建立PICC临床路径管理制度，规范PICC技术操作、技术维护质量标准等措施，实现PICC医护一体化管理模式。　结果　医护一体化管理模式能有效地提高医护工作效率，降低PICC并发症，患者满意度提高。　结论　实施肿瘤患者化学疗法PICC路径医护一体化的管理模式，使护理工作流程更加合理化，PICC技术管理更加规范，可为患者节约住院费用，并加快病床周转。