In the recent years,infringement on patients' privacy in medical activities is drawing wider attention.In medical practice there exit some common phenomena of this kind,such as some medical staff spreading the information of medical record to irrelevant people,going beyond their duty to pry into or deliberately disclose patients privacy,intentionally harass of directly intrude upon patients' private parts,etc.These problems can be gradually reduced or avioded by strengthening medical staff's awareness of self-discipline,offering related education and advice to patients,and perfecting relevant laws and regulations.

Objective To study the effects of intestinal trefoil factor(ITF) on inducible nitric oxide synthase(iNOS),tumor necrosis factor-?(TNF-?) and NO density in neonatal rat model of necrotizing enterocolitis(NEC). Methods Forty neonatal rats were randomly divided into five groups: Group A, NEC+ ITF 0.5 mg; Group B, NEC+ ITF 0.2 mg; Group C, NEC+ N.S 0.5 ml; Group D, NEC+ N.S 0.2 ml; Group E, normal control. NEC model was established as following method: one-day old Wistar rats were put into 100%carbon dioxide for 5 min and then 100% oxygen for 5 min before returned to their mothers. This was done once daily for 3 days. On the 4th day, all rats were sacrificed and the intestinal tissue located at the boundary of ileum and cecum was obtained for histological examination by HE staining and iNOS, TNF-? and NO level by immunohistopathology. Results iNOS was found negative in group A, B and E, but positive in group C and D. The density of TNF-? were significantly decreased in group A[(30.515?2.731) pg/mg?pro] and B[(32.229? 4.978) pg/mg?pro] than that in group C[(39.957?8.283) pg/mg?pro] and D[(39.960?8.374) pg/mg?pro, P 0.05)]. The density of NO were significantly decreased in group A[(0.37?0.07) ?mol/mg tissue] and B[(0.54?0.08) ?mol/mg tissue] than that in group C[(0.76?0.01) ?mol/mg tissue] and D[(0.82? 0.04) ?mol/mg tissue ( P 0.05)]. The TNF-? and NO expression showed no difference among group A and B, group C and D. The pathological lesions indicate that severe intestinal tissue necrosis in group C and D, and mild in group A and B. Conclusions Intestinal inflammation could be ameliorated after ITF injection hypodermically or intraperitoneally. ITF may provide a brand-new way for the management of NEC in neonatal rats.

In order to study the possible role of soluble interleukin-2 receptor (slL-2R) in the pathogenesis of vitiligo, we measured the levels of slL-2R in the sera and the tissue fluids from skin lesions and uninvolved skin from 41 patients with vitiligo, using the method of sandwich ELISA with monoclonal and polyclonal antibodies. The results showed that the overall level of serum sIL-2R from patients with vitiligo was significantly higher, than that from normal control group (P0.05). The level of serum sIL-2R from patients with vitiligo in progressive stage was significantly higher than that in stable stage (P

Objective: To explore the potential influencing factors of the quality guidelines for medical treatment by factor analysis.Method: We analyzed with the SPSS package 9 quality guidelines for medical treatment in the department of integrated TCM and Western medicine of a hospital,including the out-patient person-time,the number of discharges,the average days of hospitalization,the rate of bed utilization,the frequency of bed rotation,the rate of cure and improvement,the case fatality rate,the coincidence rate of diagnoses at admission and discharge,and the success rate of emergency treatment.Results: Four common factors were extracted,namely,the quantifiable factor,determined by the out-patient person-time,the number of discharges,the average days of hospitalization and the frequency of bed rotation;the treatment factor,determined by the cure and improvement rate and case fatality rate;the diagnostic factor,determined mainly by the rate of bed utilization and the coincidence rate of diagnoses at admission and discharge;and the emergency treatment factor,determined by the success rate of emergency treatment.The cumulative contribution rate of the 4 factors was 85.1%.Conclusion: The amount of medical work,the techniques of treatment,the ability of diagnosis and the efficiency of emergency rescue are the main influencing factors of quality guidelines for medical treatment.

Adult ; Endocarditis, Bacterial ; microbiology ; Enterococcus faecium ; Humans ; Male

Objective To observe the muscles and skeleton involvement surrounding sacroiliac joint (SIJ) of axial seronegative spondyloarthropathy (SPA) patients with magnetic resonance imaging (MRI),and to analyze the relationship between them.Methods A prospective study of 38 patients who meet the 2009 axial SpA diagnostic criteria was conducted.We carried out MRI of the SIJ for these patients to evaluate the muscles and skeleton involvement.Those cases were divided into muscles differences between the two groups of image scores,including Spondyloarthritis Research Consortium of Canada (SPARCC) scores and Spondyloarthritis Research Consortium of Canada MRI Sacroiliac Joint Structural Score (SPARCC SSS).The extent of muscles edema in patients with sacroiliac joints was ranked into twelve grades from 0-12,and we did Spearman rank correlation test of muscles edema scope and two indexes.Results We found that 28 cases (73.68％) of the 38 patients had significant muscle involvement by analyzing the STIR sequence,and found erector spinae in 22 cases (57.89 ％)gluteal muscles in 13 cases (34.21 ％),iliacus muscle in 11 cases (28.95 ％),obturator muscle in 5 cases (13.16％),piriform muscle in 5 cases (13.16％) and other 4 cases (10.53％).SPARCC (t =2.28,P =0.03) and SPARCC SSS (t =3.37,P =0.00) were statistically different between the two groups.SPARCC (P =0.00,r =0.67) and SPARCC SSS (P-0.01,r =0.47) were positively correlated with the extent of muscles edema.Conclusions The muscles edema around sacroiliac joint is an important sign of axial SpA magnetic resonance imaging.Patients who had muscles edema tended to have more serious skeleton changes.

ObjectiveTo detect mRNA and protein expression of steroidogenic factor-1 ( SF-1 ) and DAX-1 in human adrenocortical tumors and normal adrenal cortex,and to investigate the effect of SF-1 and DAX-1 on the steroidogenesis and development of adrenocortical tumors.Methods Total RNA and protein was extracted from angiotensin Ⅱ unresponsive aldoterone-producing adenomas ( A Ⅱ -U-APA,n =12 ),angiotensin Ⅱ responsive aldoterone-producing adenomas ( AⅡ -R-APA,n =5 ),cortisol-producing adenomas ( CPA,n =10 ),adrenal nonfunctional adenomas ( NFA,n =10 ),aldosterone-producing carcinoma ( APC,n =2 ) and normal adrenal cortex ( NAC,n =8).To analyze gene expression of SF-1,DAX-1,ACTH receptor(ACTHR),and β-actin by real-time quantitative PCR in different tissues.The protein expression of SF-1,DAX-1,and β-actin in the same tissues by Western blot.To study the relationship of ACTHR,SF-1,and DAX-1 with clinical data in adrenocortical tumors.ResultsThe expression of SF-1,DAX-1 mRNA and protein was different in NAC,AⅡ -U-APA,A Ⅱ -R- APA,APC,CPA,and NFA tissues [ relative expression of SF-1 mRNA:24.58±2.45,23.89±3.17,21.59±3.00,(38.75,44.16),14.17±2.80,and 36.38±3.50; DAX-1 mRNA:0.57±0.06,0.37±0.05,0.43±0.05,( 1.52,1.21 ),0.39 ±0.04,and 0.83 ±0.08 ; SF-1 protein:0.76 ±0.11,0.76 ±0.10,0.73 ±0.07,(1.24,1.40),0.55±0.04,and0.98±0.10; DAX-1 protein:0.65±0.14,0.39±0.13,0.43±0.14,(1.18,1.02),0.56±0.04,and 1.03±0.13 ; all P＜0.05 or P＜0.01 ].There was negative correlation by higher SF-1/DAX-1 ratio and tumor size in AⅡ -U-APA tissues.The mRNA and protein expression of SF-1 was lower in CPA and there was the positive correlation with tumor size.Conclusion SF-1 and DAX-1 might play a key role in the development of the adrenocortical tumorigenesis and steroidogenic tissues.

Objective The aim of this study was to investigate the clinical significance of CDKN1C positive expression in bone marrow in patients with myelodysplastic syndrome and secondary acute myeloid leukemia.Methods 125 patients with MDS/AML were selected as the research subjects,and selected 20 healthy subjects as a healthy control group.The mRNA and protein ex-pression levels of CDKN1C in CD34 +cells of MDS/AML patients were analyzed.The expression levels of CDKN1C were compared with those of MDS patients.The survival rate of patients with MDS and AML was analyzed by Cox regression analysis.The survival rate of MDS patients with different expression levels of CDKN1C was also analyzed.Results The expression of CDKN1C at levels of mR-NA and protein in bone marrow CD34 +cells of MDS/AML patients were significantly higher than those in healthy controls(P <0.05).There has a positive correction with BM(P<0.05).The survival rate of CDKN1C high expression group was significantly low-er than that in the low and mediate CDKN1C expression groups(P<0.05).The results of Cox regression analysis showed that age, high BM count,cytogenetic difference and the positive expression of CDKN1C significantly affected the survival rate of patients with MDS/AML(P< 0.05);The survival rate of MDS/AML chemotherapy in the CDKN1C positive group was significantly lower than that of CDKN1C negative expression group(P<0.05).The survival rate of MDS/AML after chemotherapy AlloSCT CDKN1C positive ex-pression group was significantly lower than that of CDKN1C negative expression group(P<0.05).Conclusion The expression of CDKN1C in bone marrow of MDS/AML patients was significantly increased,and the positive expression of CDKN1C significantly in-creased,and the positive expression of CDKN1C significantly affected the survival rate of MDS/AML patients.

Objective To investigate the clinical significance and changes of serum complement in lipid metabolism disorder in patients with fatty liver disease.Methods One hundred and forty patients with FLD from October 2015 to May 2017 were included in the study,in addition,120 patients with hyperlipidemia(the hyperlipidemia group)and 130 healthy subjects(the control group)in the same period were enrolled as controls.The differences in serum lipid,liver function enzymology,immunoglobulin,serum complement among the three groups were compared.Results There were significant differences in the levels of TC,TG,HDL-C,LDL-C,apoA and apoB among the three groups(TC:(5.7±1.6)mmol/L vs.(4.2±1.0)mmol/L vs.(3.5±1.1) mmol/L,F=105.01,P<0.05;TG:(2.8± 0.6)mmol/L vs.(1.5 ± 0.3)mmol/L vs.(1.1 ± 0.2)mmol/L,F=628.46,P<0.05;HDL-C:(1.2±0.3)mmol/L vs.(1.5±0.3)mmol/L vs.(1.8±0.4)mmol/L,F=107.10, P<0.05;LDL-C:(3.6±0.9)mmol/L vs.(3.0±0.8)mmol/L vs.(2.2±0.6)mmol/L,F=109.07,P<0.05;apoA:(1.0±0.2)g/L vs.(1.2±0.2)g/L vs.(1.4±0.3)g/L,F=95.20,P<0.05;apoB:(1.1±0.2)g/L vs.(0.9±0.2)g/L vs.(0.8±0.2)g/L,F=79.04,P<0.05).The levels of TC,TG,LDL-C and apoB in the FLD group were significantly higher than those in the hyperlipidemia group and the control group.The levels of HDL-C and apoA in the FLD groups were significantly lower than those in the hyperlipidemia group and control group.The levels of TC,TG,LDL-C and apoB in the hyperlipidemia group were significantly higher than those in the control group.The levels of HDL-C and apoA in the hyperlipidemia group were significantly lower than those in the control group.There were significant differences in the levels of GGT,ALT,AST,IgG and IgM among the three groups(GGT:(77.4±15.3)U/L vs.(43.3±10.6)U/L vs.(25.5±8.2)U/L,F=668.12,P<0.05;ALT:(61.5±18.8)U/L vs.(35.7±11.2)U/L vs.(18.9±5.4)U/L,F=355.67,P<0.05;AST:(55.3±12.2)U/L vs.(32.4±12.5)U/L vs.(14.4±4.7)U/L,F=521.80,P<0.05;IgG:(15.7±3.9)g/L vs.(11.6±3.2)g/vs.,(8.5±2.6)g/L,F=162.34,P<0.05;IgM:(1.9±0.6)g/L vs.(1.2±0.4)g/L vs.(0.8±0.3)g/L,F=201.38,P<0.05).The levels of GGT,ALT,AST,IgG and IgM in the FLD group were significantly higher than those in the hyperlipidemia group and the control group.The levels of GGT,ALT,AST,IgG and IgM in the hyperlipidemia group were significantly higher than those in the control group.There were significant differences in the levels of C3,C5,ASP and BF among the mild,moderate and severe fatty liver patients(C3:(2.1±0.4) g/L vs.(1.8±0.3)g/L vs.(1.0±0.2)g/L,F=436.37,P<0.05;C5:(92.3±10.7)mg/L vs.(71.8±8.8) mg/L vs.(58.9±6.5)mg/L,F=486.09,P<0.05; ASP:(51.4±6.8)nmol/L vs.(42.5±4.4)nmol/L vs.(32.8±5.2)nmol/L,F=369.29,P<0.05;BF:(0.48±0.13)g/L vs.(0.34±0.09)g/L vs.(0.23±0.04) g/L,F=233.39,P<0.05).The levels of C3,C5,ASP and BF in the FLD group were significantly higher than those in the hyperlipidemia group and the control group.The levels of C3,C5,ASP and BF in the hyperlipidemia group were significantly higher than those in the control group.There were significant differences in the levels of C3,C5,ASP and BF among patients with mild,moderate and severe fatty liver disease(C3:(1.8±0.3)g/L vs.(2.1±0.4)g/L vs.(2.5±0.4)g/L,F=30.85,P<0.05;C5:(80.5±9.6)mg/L vs.(92.3±10.5)mg/L vs.(100.7±8.)mg/L,F=39.39,P<0.05; ASP:(42.4±6.3)nmol/L vs.(52.8±5.7)nmol/L vs.(61.9±5.6) nmol/L,F=98.19,P<0.05;BF:(0.33±0.12)g/L vs.(0.45±0.11)g/L vs.(0.57±0.09)g/L,F=41.26,P<0.05).The levels of C3,C5,ASP and BF in the mild FLD patients were significantly lower than those in moderate and severe FLD patients.The levels of C3,C5,ASP and BF in the moderate FLD patients were significantly lower than those in severe FLD patients.Conclusion The detection of C3,C5,ASP and BF levels based on routine testes has important clinical value for the assessment of the condition,the treatment and the prognosis of FLD patients.

Objective To investigate the feasibility,security,indication and prophylactic measures of postpartum hemorrhage during the fetalintrapartum operation by analyze the maternal prognosis after intrapartum fetal operation(IFO) performed.Methods We performed a retrospective evaluation of 10 cases that has been performed intrapartum fetal operation(IFO group,n=10) successfully between August 2008 and October 2009 at Department of Obstetrics and Gynecology,Shengjing Hospital,China Medical University.Healthy pregnant women(n=10) were chosen as control group,who received Caesarean section for refusing to vaginal delivery.Between the two groups,we compared the indexes including blood lose during the operation and 24 hours post-operation,the hemoglobin level pre-operation and 24 hours post-operation,the involution of uterus,the puerperal infection,and the follow-up at 42 days post-operation.Results Good involution,no primary and secondary postpartum hemorrhage and no puerperal infection were found in both of the 2 groups.Intra-operation,24 hours post-operation and the total volumes of blood lose,the hemoglobin level before operation,24 hours post-operation and 42 days post-operation had no statistic significant difference between the IFO group and control group(P>0.05).No significant difference was found in the operation time between IFO group and the control group(66.40±53.40 minutes and 34.50±4.97 minutes,respectively.Intra-operation,24 hours post-operation and the total volume of blood lose had no relation to the maternal age and gestational weeks(P>0.05).The blood lose of intra-operation in IFO group had positive linear correlation to the operation time.(Pearson relation coefficient R=0.458,.P=0.021).The linear recurrence equation was:the volumes of blood lose intra-operation(ml)=172.68+1.342x(operation time).Conclusion IFO was safe to the mother.It did not affect the involution of uterus and could not increase the blood lose of postpartum and the puerperal infection morbidity.Through the effective measures of preventing postpartum hemorrhage,the postpartum blood lose of the patients that performed intrapartum fetal operation could be no more than that of the patients that had normal Caesarean section.Improving the technique of the intrapartum fetus operation and shortening the operation time are important to prevent postpartum hemorrhage.