OBJECTIVE To analyze predisposing factors and investigate the measures to fungemia.METHODS The clinical features,therapy and outcome of 17 patients with fungemia which happened from 1995 to 2004 were(retrospectively) reviewed.RESULTS The morbidity of fungemia was 5.52% in all septicemia in our hospital.Candida(tropicalis) and C.albicans were the major fungal species.There were 6 patients found cultured fungi on local(foci).Tracheotomy and mechanical ventilation (47.06%),indwelling urinary catheter(41.18%),indwelling(central) venous catheter and drainage tube(41.18%),persisted use of broad spectrum antibiotic(76.47%),(chemical) therapy(17.65%),admission to ICU(29.41%),and neutropenia(29.41%) might be the predisposing(factors).The mortality of fungemia was 70.59%.CONCLUSIONS The morbidity of non-C.albicans fungemia is(increasing),preemptic therapy should be begun earlier.Higher dose of fluconazole may be recommended in clinical usage.

Objective To explore the expressions of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 in breast cancer and their relationship with clinicopathology.Methods The expressions of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 proteins were detected in 80 cases of patients with breast cancer using immunohistochemical Streptavidin-Perosidase(SP) method,and were analyzed with clinical and medical records.Results The positive expression rates of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 in breast cancer were 60.0％,57.5％,45.0％,80.0％,48.8％ and 82.5％,respectively.In addition to C-erbB-2 which had correlation with lymph node metastasis,other five indicators showed no significant correlations with patient age,lymph node metastasis,tumor size and pathological grade.Conclusion There is a certain correlation in the expressions of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 in breast cancer.Combined detection is valuable in the treatment and prognostic evaluation of breast cancer.

Objective: To study the relationship between immune function and psychosocial factors of patients with malignant tumors Method:37 inpatients with malignant tumors were collected They had no chemotherapy or radiotherapy in the past month and without history of immune disease or medication influencing immune system 37 inpatients of internal department without tumor were collected as control All subjects completed EPQ, SCL-90, SAS, SDS, LES, SSRS and DSQ Researchers assessed their mood with HAMA and HAMD, and their immune function by measuring serum IgG, IgA, IgM, C 3, C 4, CH50 and sub-groups of lymphocyte Results:Study group had lower IgM and less CD 16 + than control The level of IgM was associated with course of disease, educational level, gender, personality, defense style, negative life events and social support The level of CD 3 + was associated with depression in addition to other factors mentioned above Conclusion: Patients with malignant tumors have immune dysfunction, which associated with psychosocial factors such as negative life events, social support and depression

Objective To observe the impact of different surgical procedures on ovarian reserve and analge-sic effects of drug use in patients with uterine fibroids.Methods 100 patients with uterine fibroids were randomly divided into two groups.50 patients in control group were implemented traditional open surgery.50 cases in the obser-vation group received laparoscopic myomectomy.The ovarian reserve changes were compared before and after surgery, pain medication use and changes in the degree of pain conditions.Results The levels of follicle stimulating hormone and luteinizing in the control group one,three months after operation were significantly higher than before surgery and the observation group,the level of estrogen was significantly lower than before surgery and observation group,the differences were statistically significant(t=10.23,14.58,9.78,11.76,9.83,9.92,10.07,11.23,all P<0.05).The postoperative first pain time of the observation group was significantly longer than the control group,the difference was statistically significant[(513.74 ±284.52)min vs.(61.38 ±37.21)min,t=92.34,P<0.05].The postoperative analgesic usage of the observation group was significantly lower than the control group,the difference was statistically significant(14.0% vs.58.0%,χ2 =7.83,P<0.05).The pain scores 3d,4d,5d,6d and 7d after operation of the observation group were significantly lower than the control group(t=2.11,2.30,2.58,7.03,6.46,all P<0.05). Conclusion The patients with uterine fibroids laparoscopic myomectomy for treatment will not cause great impact on the patients'ovarian reserve,and can effectively reduce the use of analgesics,and it is worthy of further promotion.

To understand the continuing medical education status of Beijing Shijitan Hospital,so as to continue to reform and improve the teaching management of continuing medical education.,literature and information retrieval methods were used and relevant personnel was interviewed about the content,form,time and suggestions of continuing medical education.The results indicate the presence of training content is too wide,training methods are too simple,and there is lack of medical humanities quality training and other issues in continuing medical education.Variety of training methods should be increased,the quality of medical humanities education and training should be enhanced,featured training should be developed to make the continuing medical education more scientific,standardized and highly efficient.

Hypofractionated three-dimensional confornul radiotherapy (3DCRT) makes it possible to further improve loeal control,overall survival and the quality of life for the patients with non-small-cell lung cancer (NSCLC).But the dose-fractionation and total dose are not yet clear,which need further study.Hypofractionated stereotactic body radiotherapy (SBRT) for early-stage NSCLC patients is well tolerated and results in excellent local control and overall survival.SBRT is expected to become a new standard treatment in patients with early stage NSCLC.

AIM:To investigate the effect of NF-κB binding element deletion on transcriptional regulation of (NOX1).METHODS:pGL3-Basic vector inserted with the NOX1 proximal promoter, and the same vector inserted with the NOX1 proximal promoter in the absence of the positive NF-κB binding element, were constructed.After cloning, diges-tion and purification, NOX1 proximal promoter (≈1 415 bp) was inserted into the multicloning site of the pGL3-Basic vec-tor and then sequenced ( pGL3-NOX1-1415) .NF-κB binding elements in the NOX1 promoters were predicted by Alibaba 2.1 software.The positive element was deleted by overlapping PCR.The deletion mutant was inserted into the pGL3 vector in the same way (pGL3-NOX1-1327).The plasmids were transfected into A549 cells, and then the cells were stimulated with TNF-α.The luciferase activity was monitored on MD SpectraMax M5 enzyme-labeled instrument.RESULTS:The se-quences of pGL3-NOX1-1415 and pGL3-NOX1-1327 were identified to be correct.Compared with control group, the lucif-erase activity was significantly higher in the cells transfected with pGL3-NOX1-1327 (P<0.05), but it was significantly lower than that in the cells transfected with pGL3-NOX1-1415 (P<0.05).CONCLUSION: NF-κB plays an essential role in the transcriptional regulation of NOX1 in TNF-α-induced A549 cells.Activated NF-κB binds to specific elements in NOX1 promoter regions to control the transcription.

Objective To explore the correlation between executive function and white matter lesions (WML) and the diagnostic value by clock drawing test(CDT) in patients with vascular dementia (VaD). Methods Twenty-seven VaD patients and twenty-five normal control subjects were evaluated with CDT to assess the executive function. CDT was scored according the four point method. Age-related white matter change rating scale (ARWMCrs) was used qualitatively to measure and locate the WML by cranial MRI scanning. Results 1. The scores of CDT in normal cognition health and VaD were ( 3.88 ± 0. 33 ) and ( 1.74 ± 0. 98 ). The difference between two groups was statistically significant (P＜0. 01 ). The humerous part and the point part were the earliest to decline in the VaD Patients. The scores of WML were (5.12 ± 4. 19) and ( 11.19± 3.09), respectively. There was significant difference between two groups(P ＜ 0. 01 ). The scores of CDT had significant positive correlation with MMSE scores and negative correlation with WML scores (P ＜ 0. 01 ). Conclusion The executive functional impairment in patients with VaD could be associated with the degree of WML.

Background p21 is a cyclin-dependent kinase inhibitor,and it can prevent cells from going through the G1/S phase checkpoint and inhibit cell proliferation.Stuies determined that the expression level of p21 WAF1/CIP1 is associated with proliferative diseases.Traumatic proliferative vitreoretinopathy (PVR) is a proliferative response of eye.Understaining the relationship of dynamic expression levels of p21 WAF1/CIP1 in PVR is of significance for the prevention and management of PVR.Objective This study was to investigate the expression of p21 WAF1/CIP1 during the course of experimental traumatic PVR in rabbits.Methods Fifty-four pigmented rabbits were randomized into the normal control group and different experimerital groups,and one lateral eye of each rabbit served as experimental eye.PVR models were established by intravitreal injection of human platelet-rich plasma (PRP) (0.4 ml)combined with cryotherapy for 5 seconds,and vitreous and retinas were examined with B type sonography.The rabbits were sacrificed in 7,14,21 and 28 days after operation,and histopathological examination of the retinas was performed by haematoxylin and eosin stain.The expression levels of p21WAF1/CIP1 protein and gene were detected by immunohistochemistry,Western blot and reverse transcription-PCR (RT-PCR).The use and care of the rabbits complied with Statement of ARVO.Results B type sonography showed that the retinal morphology was normal in the normal control group.However,the proliferative membrane was gradually thickened 1 to 7 days after operation.Retinal folds of rabbits were seen in 7 days,and tractional retinal detachment was found in 14 days and 28 days after operation.The histopathological examination of the retinas showed epiretinal membrane and infiltration of inflammatory cells 7 days and fixed ruffle 28 days after operation.The p21WAF1/CIP1 was strongly expressed in the cell nucleus of retinal ganglion cell layer (GCL) and inner nuclear layer (INL) in the normal control group,and the expression was gradually weakened after modeling,with the weakest expression in the retinas in 14 days after modeling.The relative expression levels of p21 WAF1/CIP1 protein was 0.74±0.08,0.60±0.05,0.56±0.03,0.74±0.02 and 0.65 ±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,showing a significant difference among the groups (F =20.55,P =0.00),and the expression levels of p21WAF1/CIP1 protein were significantly lower in the postoperative 7-day group and postoperative 14-day group than those of the normal control group,postoperative 21-day group and postoperative 28-day group (all at P＜0.05).The relative expression levels of p21 WAF1/CIP1 mRNA was 0.65 ± 0.09,0.57 ± 0.05,0.45 ±0.04,0.46±0.02 and 0.47±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,with a significant difference among the groups (F =18.06,P =0.00),and the expression levels were significantly lower in the postoperative 14-day group,postoperative 21-day group and postoperative 28-day group than those of the normal control group and postoperative 7-day group (all at P＜0.05).Conclusions The dynamic expression of p21WAF1/CIP1 in the retinas is consistant with the prograssion of traumatic PVR,and the reduce tendency of p21 WAF1/CIP1expression is similar to cell prolieration change,indicating that reduce of p21WAF1/CIP1 expression in the retinas may promote the development of traumatic PVR.

Objective To detect the influence of rapamycin on the expression of 4 kinds of miRNAs and the effect cell autophagy.To study the relationship of miR-144 and Beclin-1 gene.Methods SKOV-3 cells were treated with 50 ng/mL rapamycin 2 hours and 10 nmol/L 3-methyl adenine 12 hours,the expression of miR-17,miR-20a,miR-144 and miR-155 was detected by RT-qPCR in SKOV-3 cell of different groups,the protein expression of Beclin-1 was detected by Western blot.The targeting effect of miR-144 on Beclin-1 gene was verified by the dual-luciferase reporter assay,Western blot and RT-qPCR.Results The expression of miR-17,miR-144 and miR-155 were in creased compared with NC groups in rapamycin group (P＜0.05);miR-17,miR-20a and miR-144 were down regulated compared with NC group in 3-MA group(P＜0.05);the protein of Beclin-1 was down expression compared with NC group in rapamycin group.miR-144 could suppress Beclin-1 expression by targeting the specific 3'untranslated region sequence of Beclin-1 gene.Conclusions miR-144 can inhibit the autophagy-related gene Beclin-1 expression and regulate the autophagy process in SKOV-3 cells.