Objective To understand the epidemiological characteristics of a healthcare-associated infection(HAI)outbreak due to Norwegian scabies in a hospital,and provide basis for clinical prevention and control of HAI.Methods Through epidemiological investigation,all suspected patients and close contacts were investigated and traced,three dimensional distribution of patients was described,a series of effective comprehensive prevention and control measures were formulated and implemented.Results A total of 16 cases of Norwegian scabies infection occurred in November 3-16,2015,the most frequent cases were in November 11(n=5),the onset time of infection was concentrated in November 9-11(n=10),accounting for 62.50%of total cases.Spatial distribution of 16 cases: 12 cases were in general internal medicine department,2 in nursing department,and 2 were relatives of employees.Population distribution: patients aged 50-59(n=7),female(n=13),and nursing staff(n=9).After taking comprehensive prevention and control measures and medication treatment,16 infected persons were all cured,the cure rate was 100%,there was no new cases occurred in the hospital,epidemic was under control.Conclusion Norwegian scabies is highly contagious,it can cause epidemic in local area.In order to avoid spread of scabies infection in hospital,health care workers should strengthen the diagnosis and precaution level of the disease.

OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refrac-tory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treat-ed with Ziprasidone hydrochloride capsule 80-120 mg,twice a day+Olanzapine tablet(the usage was the same as control group). The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight, BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were sta-tistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not signifi-cant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment (P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olan-zapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar, however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.

Objective To investigate the causes of misdiagnosis and improve the level of diagnosis and treatment for endocrine myopathy,through the study the clinical data of 20 patients with endocrine myopathy who were misdiagnosed as polymyositis were analyzed.Methods 20 cases were retrospectively analyzed who suffered from proximal weakness as the main performance and misdiagnosed as polymyositis,through the method of supervision to track,review of the observation and methods of medical record information query.Results The main types of diseases which were misdiagnosed including 18 patients of thyroid diseases(13 patients of hypothyroidism,5 patients of hyper-thyroidism),2 patients of parathyroid disease(1 patient of hyperparathyroidism,1 patient of hypoparathyroidism). Conclusion Mastering polymyositis and endocrine myopathy in the identification of main points,improving the ability of differential diagnosis,so that doctor can avoid misdiagnosis.

Objective To summarize the experience of emergency treatment of primary liver cancer rupture bleeding and improve the level of diagnosis and treatment of the disease.Methods From October 2008 to December 2012.The clinical data of 11 patients with spontaneous rupture of primary liver cancer were analyzed retrospectively.Results Three cases were given conservative treatment.Among them,1 case died,2 bleeding cases were hemostasis,8 cases were operated.Surgical operation is the main method of emergency treatment.The effect after operation was satisfactory.1 case with liver tumor resection died in the first days after the operation,1 case was transferred to higher level hospitals for further treatment because massive ascities in third days after operation,6 cases were successfully discharged,survival rate was over 3 months.Conclusions In the process of emergency treatment we should pay attention to reduce the rate of misdiagnosis and missed diagnosis.When the diagnosis was confirmed,we must treat the shock and plan an active operation scheme.Operation mode can be selected of tumor resection or simple hemostatic gauze tamponade suture hemostasis,saving lives of patients in the shortest time is the goal of emergency treatment.

0.05). Conclusion Peaks of serum gonadotropin and sex hormone concentrations are reached at 2~4 months of age and sexual dimorphism is shown, suggesting that in boy and girl infants, different mechanisms may be involved in regulating the development of gonads.

Objective: To study therapeutic effect of personalized aerobic exercise based on exercise load test assessment on heart function and psychological state in patients with acute myocardial infarction (AMI). Methods: According to random number table, a total of 80 AMI patients during recovery period were randomly and equally divided into routine treatment group (n=40, received routine drug therapy) and exercise group (n=40, received personalized aerobic exercise based on exercise load test assessment on the basis of routine treatment group). Serum levels of high-sensitivity cardiac troponin I (hs-cTnI) and creatine kinase isoenzyme MB (CK-MB), and left ventricular ejection fraction (LVEF), stroke volume (SV), left ventricular fractional shortening (LVFS), ventricular wall thickening rate (△T), motion amplitude of interventricular septum (AIS), and scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were compared between two groups before and after 12-week intervention. Results: Compared with before intervention, there were significant reductions in serum levels of hs-cTnI and CK-MB, and scores of SAS and SDS; and significant rise in LVEF, SV, LVFS, △T and AIS in both groups after 12-week intervention (except LVEF of routine treatment group), P<0.05 or <0.01; compared with routine treatment group, there were significant reductions in serum levels of hs-cTnI [(9.31±1.04) ng/L vs. (5.89±0.72) ng/L] and CK-MB [(11.34±1.25) U/L vs. (8.41±1.01) U/L],in scores of SAS [(51.34±6.54) scores vs. (42.32±5.29) scores] and SDS [(50.23±6.92) scores vs. (43.86±6.03) scores];and significant rise in LVEF [(57.12±6.67)% vs. (62.32±7.34)%], SV [(62.45±7.13) ml vs. (69.18±7.84) ml], LVFS [(23.93±2.96)% vs. (28.45±3.12)%], △T [(28.51±3.41)% vs. (34.52±4.87)%] and AIS [(9.56±1.02) mm vs. (12.45±1.46) mm] in exercise group, P<0.05 or <0.01. Conclusion: Personalized aerobic exercise based on exercise load test assessment can reduce myocardial cell injury, improve cardiac function, relieve negative emotions and promote patients’ rehabilitation rapidly.

Objective To investigate the relationship between C734A and G-2964A polymorphism of cytochrome P450 1A2 gene and clinical efficacy of duloxetine.Methods 223 patients with depression were treated with duloxetine for six weeks.The clinical efficacy was evaluated with the Hamilton rating scale for depression (HAMD) ;single nucleotide polymorphism (SNP) at position C734A and G-2964A of CYP1A2 gene were identified with restriction fragment length polymorphism(RFLPs) ;then one-way ANOVA was adopted to analyze the relationship between SNP and clinical efficacy.Results (1) In 223 patients,the frequency of allele A at locus 734 was 63.64％,while that of allele A at locus-2964 was 26.82％.(2) 220 patient underwent the whole treating course.The conjoint analysis of two locuses indicated that the decreasing ratio of HAMD score of high-activity group,middle-activity group and low-activity after treatment was (56.05± 10.13) ％,(66.36± 8.66) ％ and (73.82± 7.10) ％ respectively,the differences obtained by pairwise comparison of the three groups were of statistical significance(P＜0.01).Conclusion There is close relationship between C734A and G-2964A polymorphism of CYP1A2 gene and clinical efficacy of duloxetine in the treatment for depression.

Objective To observe the effect of saxagliptin combined insulin four times to strengthen the vola-tility on blood glucose variability in patients with type 1 diabetes.Methods According to random number table meth-od,60 patients with type 1 diabetes were divided into DPP4 group(28 cases)and the control group(32 cases).The control group was given insulin four times to strengthen the volatility(insulin aspart/insulin lispro +insulin glargine /insulin detemir),the DPP4 group on the basis of insulin four times to strengthen the volatility plus the saxagliptin 5mg/d,all patients into the group after1 -3D and 13 -15D using CGMS(Medtronic)continuously monitor the blood glucose.Results (1)Within the group comparison:the DPP4 group:1 -3d after treatment:MAGE and SDBG,MBG, LAGE,PT10.0,PT3.9 were lower than before treatment,including MAGE [(6.91 ±1.63)mmol/L vs.(6.31 ± 1.42)mmol/L,t =0.993],SDBG[(2.63 ±0.81)mmol/L vs.(2.41 ±0.51)mmol/L,t =0.751],MBG[(11.51 ± 1.24)mmol/L vs.(10.87 ±2.01)mmol/L,t =1.077],LAGE[(9.43 ±1.73)mmol/L vs.(8.56 ±1.97)mmol/L, t =1.125],PT10.0[(12.99 ±5.61)% vs.(9.66 ±5.03)%,t =1.427],PT3.9[(5.51 ±2.43)% vs.(5.07 ± 2.44)%,t =1.141],there were statistically significant differences compared with before treatment(all P <0.05), 1 -3d after treatment,SDBG[(2.77 ±0.73)mmol/L vs.(2.14 ±0.69)mmol/L,t =1.547],MBG[(11.67 ± 1.46)mmol/L vs.(9.76 ±1.58)mmol/L,t =1.1.326]were decreased,but there were no statistically significant differences compared with before treatment(all P >0.05);13 -15d after treatment:MAGE[(6.88 ±1.49)mmol/L vs.(2.97 ±0.86)mmol/L,t =3.021],SDBG[(2.77 ±0.73)mmol/L vs.(1.12 ±0.43)mmol/L,t =1.964],MBG [(11.67 ±1.46)mmol/L vs.(7.44 ±0.93)mmol/L,t =2.760],LAGE[(9.55 ±1.77)mmol/L vs.(6.53 ±1.21)mmol/L, t =2.409],PT10.0[(13.58 ±5.14)% vs.(4.72 ±2.37)%,t =2.657],PT3.9[(5.36 ±2.05)% vs.(3.05 ± 2.60)%,t =1.840]were decreased,there were statistically significant differences compared with before treatment (P <0.05 or P <0.01 );the control group:1 -3d after treatment:MAGE [(6.91 ±1.63)mmol/L vs.(6.31 ± 1.42)mmol/L,t =0.993],SDBG[(2.63 ±0.81)mmol/L vs.(2.41 ±0.51)mmol/L,t =0.751],MBG[(11.51 ± 1.24)mmol/L vs.(10.87 ±2.01)mmol/L,t =1.077],LAGE[(9.43 ±1.73)mmol/L vs.(8.56 ±1.97)mmol/L, t =1.125],PT10.0[(12.99 ±5.61)% vs.(9.66 ±5.03)%,t =1.427],PT3.9[(5.51 ±2.43)% vs.(5.07 ± 2.44)%,t =1.141]were lower than before treatment,but compared with before treatment,there were no statistically significant differences(all P >0.05 );13 -15d after treatment:MAGE [(6.91 ±1.63 )mmol/L vs.(6.07 ± 1.36)mmol/L,t =1.223],SDBG[(2.63 ±0.81)mmol/L vs.(1.91 ±0.93)mmol/L,t =0.984],MBG[(11.51 ± 1.24)mmol/L vs.(8.82 ±1.13)mmol/L,t =1.808],LAGE[(9.43 ±1.73)mmol/L vs.(7.06 ±1.57)mmol/L, t =1.963],PT10.0[(12.99 ±5.61)% vs.(6.74 ±3.35)%,t =2.012],PT3.9[(5.51 ±2.43)% vs.(4.73 ± 2.57)%,t =1.541]were decreased,there were statistically significant differences in MBG,LAGE,PT10.0 compared with before treatment(all P <0.05).Group comparision:1 -3d after treatment:the DPP4 group:MAGE[(4.81 ± 1.15)mmol/L vs.(6.31 ±1.42)mmol/L,t =2.351],SDBG[(2.14 ±0.69)mmol/L vs.(2.41 ±0.51)mmol/L, t =1.332],MBG[(9.76 ±1.58)mmol/L vs.(10.87 ±2.01)mmol/L,t =0.856],LAGE[(7.74 ±1.88)mmol/L vs.(8.56 ±1.97)mmol/L,t =2.102],PT10.0 [(7.47 ±4.96)% vs.(9.66 ±5.03)%,t =2.667],PT3.9 [(4.64 ±2.14)% vs.(5.07 ±2.44)%,t =1.890]were all significantly lower than the control group,there were statistically significant differences in MAGE,LAGE,PT10.0 between the two groups(all P <0.05).13 -15d after treatment:the above indictors,the DPP 4 group was decreased obviously compared with the control group,MAGE [(2.97 ±0.86)mmol/L vs.(6.07 ±1.36)mmol/L,t =2.854],SDBG[(1.12 ±0.43)mmol/L vs.(1.91 ± 0.93)mmol/L,t =2.328],MBG[(7.44 ±0.93)mmol/L vs.(8.82 ±1.13)mmol/L,t =2.125],LAGE[(6.53 ± 1.21)mmol/L vs.(7.06 ±1.57)mmol/L,t =2.111],PT10.0[(4.72 ±2.37)% vs.(6.74 ±3.35)%,t =2.312] and PT3.9 [(3.05 ±2.60)% vs.(4.73 ±2.57)%,t =2.237],there were statistically significant differences between the two groups (P <0.05 or P <0.01).Conclusion The combination of DPP4 inhibitors and insulin four renforcement can improve blood glucose fluctuation in patients with type 1 diabetes,reduce the dosage of insulin and not increase incidence of hypoglycemic events.

Breast cancer is the most common cancer in women, and approximately 90% of breast cancer deaths are caused by local invasion and distant metastasis of tumor cells. Epithelial-mesenchymal transition (EMT) is a vital process for large-scale cell movement during morphogenesis at the time of embryonic development. Tumor cells usurp this developmental program to execute the multi-step process of tumorigenesis and metastasis. Several transcription factors and signals are involved in these events. In this review, we summarize recent advances in breast cancer researches that have provided new insights in the molecular mechanisms underlying EMT regulation during breast cancer progression and metastasis. We especially focus on the molecular pathways that control EMT.
Breast Neoplasms ; pathology ; physiopathology ; Cell Transformation, Neoplastic ; Disease Progression ; Drug Resistance, Neoplasm ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Neoplasm Metastasis ; Neoplastic Stem Cells ; pathology ; physiology ; Signal Transduction

The effects of cardiomyocyte grafting on left ventricular (LV) remodeling and function in rats with chronic myocardial infarction were evaluated using high-frequency ultrasound. Chronic myocardial infarction was induced in 50 Wister rats by ligating the left anterior descending artery. They were randomized into two groups: a trial group that received neonatal rat cardiomyocyte trans- plantation (n=25) and a control group which were given intramyocardial injection of culture medium (n=25). The left ventricular (LV) geometry and function were evaluated by high-frequency ultrasound before and 4 weeks after the cell transplantation. After the final evaluation, all rats were sacrificed for histological study. The results showed that 4 weeks after the cell transplantation, as compared with the control group, the LV end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume were significantly decreased and the LV anterior wall end-diastolic thickness, LV ejection fraction and fractional shortening were significantly increased in the trial group (P<0.01). Histological study showed that transplanted neonatal rat cardiomyocytes were found in all host hearts and identified by Brdu staining. It was suggested that transplantation of neonatal rat cardiomyocytes can reverse cardiac remodeling and improve heart function in chronic myocardial infarction rats. High-frequency ultrasound can be used as a reliable technique for the non-invasive evaluation of the effect of cardiomyocyte transplantation.