Minichromosome maintenance proteins are novel cell proliferation markers. These proteins have demonstrated clinical values in cancer diagnosis, prognosis, and screening, and have shown promising potentials in targeted treatments of cancer.

This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.

Child ; Disease Susceptibility ; etiology ; Environmental Exposure ; Environmental Pollutants ; Health Status ; Humans

Child ; Health Knowledge, Attitudes, Practice ; Humans ; Lead Poisoning ; prevention & control

Child ; China ; Humans ; Lead Poisoning ; prevention & control ; Public Health Practice

Objective To discuss the relationship between the fracture of the clavicle which was fixed by tor-sional-shaped plate and nonunion after operation.Methods Retrospective analysis was conducted in 426 patients with midshaft clavicle fractures.Among the patients,the A group used torsional-shaped plate to meet the anatomical structure of the clavicle:the medial plate matched under the front face of the clavicle,and the lateral plate matched the up face of the clavicle.And the traditional method was used in the B group.Patients were followed up for at least 12 months,the patients were judged by X-ray criteria for nonunion.Results A total of 28 patients with nonunion, including 4 cases in A group,24 cases in B group.After statistics processing,the difference between A group and B group was significant (χ2 =6.679,P=0.010).Conclusion We find that the treatment of the fracture of the middle part of the clavicle with torsional-shaped plate can effectively reduce the incidence of nonunion.

BACKGROUND: Dexmedetomidine has been shown to fight against ischemia/reperfusion injury induced by tourniquets. OBJECTIVE: To study the effects of dexmedetomidine on the oxidative stress and inflammatory damage caused by tourniquet-induced ischemia/reperfusion injury. METHODS: Seventy-six patients scheduled for lower limb operation were randomized into two groups: patients in dexmedetomidine group were given the intravenous injection of 1 μg/kg dexmedetomidine for 10 minutes, followed by 0.5 μg/kg?h until the end of operation; while the controls were subjected to 0.9% saline injection at an equivalent velocity and volume. The levels of serum propanediol, lactic dehydrogenase, superoxyde dismutase, tumor necrosis factor-α, interleukin-6 and -8 were detected before tourniquet inflation, 10, 60 and 120 minutes after tourniquet release. RESULTS AND CONCLUSION: In both two groups, the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8 after tourniquet release were significantly higher and the serum superoxide dismutase level was significantly lower than those before tourniquet inflation (P < 0.05). Compared with the control group, dexmedetomidine significantly reduced the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8, and increased the serum superoxyde dismutase level after tourniquet release (P < 0.05). These results suggest that dexmedetomidine can attenuate the oxidative stress and inflammatory damage resulting from tourniquet-induced ischemia/reperfusion injury probably by up-regulating the serum superoxyde dismutase level, and down-regulating the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8.

Objective To evaluate the survival benefit of amphotericin B (AmB) plus flucytosine or fluconazole for treatment of patients with acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis.Methods The following database were searched from the beginning to October 2013,including Cochrane library,PubMed,OVID,Embase,Wanfang Date,CNKI and Chinese Biomedical Database,and the references of eligible studies were manually screened.Reference lists of relevant articles were screened according to selection and extraction criteria.Meta-analysis was performed using RevMan 5.2.Results Four prospective controlled studies with a total of 399 patients with cryptococcal meningitis were identified,including 386 patients with AIDS-associated cryptococcal meningitis and 13 human immunodeficiency virus (HIV)-negative patients.Two hundred and twentyseven patients were treated with AmB and flucytosine combination therapy,including 217 patients with AIDS-associated cryptococcal meningitis and 10 HIV-negative patients.One hundred and seventy-two patients were treated with AmB and fluconazole combination therapy,including 169 patients with AIDS-associated cryptococcal meningitis and 3 HIV-negative patients.The Meta-analysis revealed that the mortality rate in AmB plus flucytosine combination therapy group was 6.6％ (95％ CI:18.5％-31.6 ％) at two weeks point,which was significantly lower than that in AmB plus fluconazole combination group (19.7％,95％CI:-23.6％-62.9％; OR=0.51,95％CI:0.27-0.93,P＜0.05).But at 10 weeks point,the mortality rate in flucytosine combination group was 12.9％ (95％oo CI:-22.2％-48.0％),which was lower than that in fluconazole combination group (31.4％,95％ CI:-23.1％-85.9 ％).However,there was no statistically significant difference between these two groups at 10 weeks point (OR=0.70,95％CI:0.44-1.13,P=0.15).Conclusion Administration of AmB plus flucytosine at early stage can reduce the mortality rate in patients with AIDS-associated cryptococcal meningitis.

Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.

Objective To assess the applicability of the Modification of Diet in Renal Disease (MDRD)formula to kidney function impaired Chinese diabetic patients.Methods Glomerular filtration rates(GFRs)in 463 Chinese diabetic patients(219 female,244 male,aged 14 to 88)were estimated by measuring ~(99m)Tc-DTPA clearance and with equations based on serum creatinine(Scr)and cystatin C(Cys C)concentrations.GFRs derived from various equations were compared with the ~(99m)Tc-DTPA clearance GFRs and their relative accuracies were assessed with ROC analysis.All the Scr measurements were performed with both the Roche enzymatic assay and the Beckman LX20 kinetic alkaline picrate assay,and Cys C with immunonephelometric and immunoturbidimetric assays.Results The reciprocals of Cys C and Scr were linearly correlated with ~(99m)Tc-DTPA clearance GFRs(r=0.830 and 0.690,repectively).The correlation of GFR with Scr could be expressed by an adjusted MDRD equation:GFR [ ml?(min?1.73 m~2)~(-1)]=175?(Scr)~(-1.154)?(age)~(-0.203)?0.742(female)?0.827,where 0.827 was a coefficient for Chinese.The adjusted equation showed a better accuracy than the MDRD equation(areas under the ROC curve 0.818 vs 0.644).The adjusted equation was also more accurate than equations obtained in previous Chinese studies.GFRs were also estimated by using Cys(in mg/L)with the following equation:GFR [ ml?(min?1.73 m~2)~(-1)] = 63.24?(Cys C)~(-0.3378).The accuracy of the Cys equation was similar to the Scr equation,or better in patients aged 60 and above.The Roche enzymatic results which were traceable to the isotope dilution mass spectrometry(IDMS)methods were significantly lower than Beckman LX20 results,but the results were closely correlated with each other(Y = 0.94X-0.02).When non-traceable Scr results were used,the coefficient needed to be adjusted.Conclusions GFRs can be estimated with equations based on either Scr or Cys C.GFR estimation should use standardized Scr results and take into account ethnic effects.