Objective To study effect of carcinoembryonic antigen (CEA) positive targeted lymphocytes on gastric cancer cells in vitro and in vivo. Methods The peripheral blood mononuclear cells (PBMCs) were isolated from the peripheral blood of healthy volunteers. The recombinant vector anti-CEA-scFv-CD3ζ-pcDNA3.0 was transfected into the PBMCs by lipofectamine 2000, by this means, the CEA special lymphocytes were obtained. Meanwhile, the PBMCs transfected with empty plasmid pcDNA3.0 were used as control (empty vector lymphocytes). The different lymphocytes and gastric cancer cells (CEA positive KATOⅢ gastric cancer cells and CEA negative BGC-823 gastric cancer cells) were co-cultured, then the ability to identify the gastric cancer cells and it’s effect on apoptosis of gastric cancer cells were observed at 24 h or 36 h later respectively. The CEA special lymphocytes and empty vector lymphocytes were injected by the tail vein of nude mice bearing gastric cancer cells, then it’s effect on the tumor was observed. Results ① The CEA special lymphocytes could strongly identify the KATOⅢ gastric cancer cells (identification rate was 72.3%), which could weakly identify the BGC-823 gastric cancer cells (identification rate was 7.8%). ② The apoptosis rate of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly higher than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (P=0.032), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (P=0.118). ③ The tumor volume of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly smaller than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (F=5.010, P<0.01) or the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells (F=4.982, P<0.01), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (F=1.210, P>0.05). Conclusion CEA special lymphocytes can promote cell apoptosis and inhabit tumor reproduction of CEA positive gastric cancer cells in vitro and in vivo.
目的:研究替米沙坦对合并高血压的阵发性房颤患者转复为窦性心律后复发的影响。方法: 选择84例合并高血压的阵发性房颤患者,随机分成观察组及对照组,观察组降压药使用替米沙坦,对照组使用氨氯地平,两组均使用胺碘酮复律,随访2年,观察两组患者的疗效及超声心动图(左房内径)变化。结果:观察组治疗合并高血压的阵发性房颤复发率显著低于对照组。结论:替米沙坦联合抗心律失常药物,能有效防止房颤复发,维持窦性心律。
目的 调查安置永久性人工心脏起搏器的老年患者术前焦虑状况，为制订护理对策提供依据。 方法 2004年7月-2008年7月收治需安置永久性人工心脏起搏器的心脏病患者78例，术前采用焦虑自评量表（SAS）对其进行问卷调查，并采用自制一般情况问卷调查了解情况。 结果 植入永久性心脏起搏器的老年患者术前SAS得分高于国内常模（Plt;0.05）。根据自制调查问卷结果，差异有统计学意义（Plt;0.05）的项目:老年患者随年龄增长焦虑量表评分降低；丧偶者焦虑评分高于有配偶者；完全公费、部分公费、自费的焦虑量表评分依次增高；老年患者对起搏器知识了解程度越少，焦虑评分越高；无家人陪伴者比有家人陪伴者焦虑评分高。而性别、文化水平差异无统计学意义。 结论 植入永久性起搏器的老年患者术前多数存在焦虑情绪，且焦虑与年龄、婚姻、费用支付方式、有无家人陪伴、相关知识等有一定关系，医护人员应针对性地做好患者术前护理，帮助患者面对现实，以积极的心态接受手术治疗。
Methods To explore the level of delirium knowledge of geriatric nurses in Sichuan province and analyze the factors, so as to provide the basis for systematic and targeted knowledge training on delirium and clinical management. Methods Using the self-designed “the Questionnaire of Elderly Delirium Knowledge”, geriatric nurses from 22 hospitals in Sichuan province were investigated through a convenient sampling method from September 2018 to February 2019. Results A total of 475 geriatric nurses were investigated. The average delirium knowledge score of the 475 geriatric nurses was 69.51±12.42. Multiple linear regression analysis showed that the main factors affecting the score of delirium-related knowledge were the education of nurses (P=0.037), technical title (P<0.001), years of working in the geriatric department (P=0.001), and the level of working hospital (P=0.001). Conclusions The level of delirium knowledge of geriatric nurses is low and can not meet the needs of clinical work. Nursing managers should carry out delirium knowledge training according to the different characteristics of nurses.
Objective To discuss left ventricular reconstruction methods and effectivness in patients with left ventricular aneurysm after myocardial infarction. Methods Between June 2003 and August 2008, 23 patients with left ventricular aneurysm after myocardial infarction were treated. Of them, 13 were male and 10 were female with an average age of 61.2 years (range, 47-74 years). According to New York Heart Association (NYHA) criteria for cardiac function, there were 3 cases of grade I, 6 cases of grade II, 10 cases of grade III, and 4 cases of grade IV. The coronary arteriongraphy showed singlevesseldisease in 2 cases, double-vessel disease in 5 cases, triple-vessel disease in 16 cases. The locations of ventricular aneurysm were the apex cordis in 18 cases, antetheca and parieslateral is in 4 cases, and interior wall in 1 case. The left ventricular ejection fraction was 36.52%± 12.15%, and left ventricular diastol ic final diameter was (62.30 ± 6.52 ) mm. Nine patients received standard l inear repair, 6 patients received standard l inear repair after endocardial ring shrinkage, and 8 patients received patch suture after endocardial ring shinkage. Results Two cases died perioperatively, and re-thoracotomy was performed to stop bleeding in 1 case. Incisions healed by first intention in the other patients without early compl ication. Twentyone patients were followed up 7-48 months (median, 19 months). At 6 months after surgery, the left ventricular ejection fraction 46.52% ± 9.41% were significanly improved when compared with that at preoperation (t=2.240, P=0.023); the left ventricular diastol ic final diameter (52.23 ± 5.11) mm were significantly decreased when compared with that at preoperation (t=2.170, P=0.035). The cardiac function according to NYHA criteria was at grade I in 8 cases and at grade II in 13 cases. One patient died of cerebral hemorrhage at 18 months after operation and the activities of daily l iving recoverd in the others. Conclusion Individual theraputic methods are used according to patients’ different conditions for left ventricular aneurysm after myocardial infarction.
Objective To construct a green fluorescent protein expression plasmid pEGFP-C3-anti-TAG72 scFv-CD28, containing anti-TAG72 single chain variable fragment (scFv) fused into the transmembrane and intracellular domain of the signal-transducing chain of CD28 gene, and to transfect it into peripheral blood mononuclear cells． Methods Recombinant transmembrane and intracellular domain of CD28 cDNA and anti-TAG72 scFv cDNA fragment was subcloned into pEGFP-C3 vector. Recombinant clones were selected by Kanamyein， and then identified by PCR， enzyme digestion analysis and DNA sequencing. The recombinant plasmid was transfected into peripheral blood mononuclear cells by means of lipofection. The recombinant protein expression was confirmed by immunocytochemistry, laser scanning confocal microscope, PCR and Western blot analysis. Results The fused gene fragment of anti-TAG72 scFv-CD28 was successfully inserted into pEGFP-C3 plasmid, and it was confirmed by enzyme digestion and DNA sequencing. The fused anti-TAG72 scFv-CD28 gene and its protein was identified in peripheral blood mononuclear cells． Conclusion The eukaryotic expression plasmid pEGFP-C3-anti-TAG72 scFv-CD28 was successfully constructed and transiently expressed in peripheral blood mononuclear cells， which would lay a foundation for further studies on the role of it to activate tumor-associated antigen-specific T lymphocyte, for generating of modified T lymphocytes targeting gastrointestinal tumors.
目的 了解成都市卧床老年人的抑郁发生情况及影响因素。 方法 对2009年12月－2011年2月卧床时间＞1个月的325例卧床老年人采用老年抑郁量表、焦虑自评量表、生活满意度指数A进行调查，并对影响的抑郁的相关因素进行统计分析。 结果 成都市卧床老年人抑郁的发生率为57.5%。不同病情、生活自理能力、焦虑情况、社会交往情况、生活的满意度和家庭功能的老年人，其抑郁评分差异有统计学意义（P＜0.05）。多重线性回归分析发现影响老年人抑郁的主要因素有病情、卧床分级、焦虑、社会活动、满意度、文化程度，其中对生活满意、有社会活动、文化程度高是保护因素，而焦虑、病情较重、卧床等级高是抑郁的危险因素。 结论 卧床老年人的抑郁发生率较高，应加强对卧床老年人，特别是病情重、焦虑、大部分或者全天卧床、低文化的卧床老人抑郁发生的关注，鼓励老年人增加社会活动、提高老年人对生活的满意度和增进他们的心理健康。
Objective To evaluate the effect of day surgery with diagnosis-related groups (DRG) evaluation indicators. Methods The inpatients undergoing surgery in Beijing Tongren Hospital of Capital Medical University between March and September 2022 were enrolled in this study. The medical quality, medical efficiency, hospitalization cost, DRG insurance payment and other DRD-related indicators were retrospectively collected and compared between day surgery patients and non-day surgery patients, and the average length of hospital stay and hospitalization costs were compared between the two surgery modes within DRGs. Chi-square test was used for enumeration data, and t-test and Mann-Whitney U test were used for measurement data. Results A total of 29339 day surgery patients and 19019 non-day surgery patients were enrolled. In the day surgery group, the proportions of local patients (71.71% vs. 68.62%), routine discharge (99.93% vs. 99.78%), and class A incisions (99.92% vs. 99.55%) were better than those in the non-day surgery group (P<0.05), and the average length of hospital stay [(1.00±0.00) vs. (6.98±5.00) d] and the average hospitalization costs [(7306.62±4605.73) vs. (24913.97±24623.54) yuan] were lower than those in the non-day surgery group (P<0.05). The top 2 reduction of average length of hospital stay were in the CB49 group and CB39 group, decreasing by 87.45% and 86.24%, respectively. The top 2 reduction of hospitalization costs were in the DC19 group and CC15 group, decreasing by 84.15% and 73.61%, respectively. DRG payment balance of medical insurance in the day surgery group was higher than that in the non-day surgery group (22.95% vs. 5.98%). Conclusions Day surgery not only ensure the medical quality, but also shorten the length of hospital stay and reduce the burden of medical expenses. Day surgery can effectively improve the utilization efficiency of hospital bed resources, it is an effective measure to promote the high quality development of hospital and comply with DRG payment reform.
目的 总结神经外科复杂脑脊髓血管病杂交手术的护理配合经验。 方法 回顾分析2011 年4 月－2012 年5月华西医院手术室完成的 56例神经外科杂交手术的临床资料，总结神经外科杂交手术的护理配合经验。 结果 所有手术均顺利进行，未出现明显危及患者安全的情况。 结论 神经外科Hybrid手术治疗复杂脑脊髓血管病较普通手术更为安全有效。但手术护理准备及配合更为复杂，在手术室布局、手术流程方面需要医护协调专门进行优化。有神经外科专业经验的护士经过一段时间专门培训后担任手术巡回及器械护士更有利于手术的顺利、安全进行。
目的 了解糖尿病患者院外自行注射胰岛素存在的风险。 方法 2010年1月－12月，通过随访调查老年组83例，中青年组69例糖尿病患者院外自行注射胰岛素的实施情况，对存在的问题进行归类、统计。调查的内容主要包括3个方面：胰岛素装置的正确使用、胰岛素的规范注射、血糖监测及低血糖处理。分析两组患者院外注射胰岛素的风险，并对存在的问题进行原因分析、提出解决方法。 结果 发放调查表152份，有效回收131份，其中老年组73份，中青年组58份。在胰岛素装置使用方面，老年组存在问题48项，中青年组27项，两者间差异无统计学意义（χ2=2.432，P＞0.05）。在胰岛素的规范注射方面，老年组存在问题176项，中青年组77项，老年组在胰岛素注射方面存在的问题明显高于中青年组（χ2=25.009，P＜0.001）。在低血糖的认识及正确处理上，老年组存在问题115项，中青年组33项，两组差异具有统计学意义（χ2=40.383，P＜0.001）。 结论 糖尿病患者院外自行注射胰岛素存在诸多风险。老年糖尿病患者院外胰岛素注射需在他人协助、监督下进行。