Objective To explore the value of the combined detection of serum AFU and AFP on predicting postoperative recurrence of hepatocellular carcinoma. Methods Three groups were classified as pathological observation group, pathological control group and health control group. AFU was detected by ratio colorimetric method with the AFU>40 U/L defined as positive values. AFP was detected by microparticle enzyme immunoassay with AFP> 13.6 μg/L defined as positive values. Results AFU and AFP level of the pathological observation group were significantly different compared with the pathological control group and health control group(P <0.001). AFU and AFP level of the pathological control group were higher than those in the health control group, but no significant difference (P >0.05). For the pathological observation group, the level of AFU and AFP after recurrence were significantly different than that before (P <0.001). As to the sensitivity and accuracy of method, AFU + AFP and AFU or AFP were significantly different (P <0.001). There was no significant difference between AFU and AFP(P >0.05). As to the specificity of method, there was no significant differences among AFU+AFP, AFP and AFU (P >0.05). Conclusion The combined detection of serum AFU and AFP levels significantly raised the diagnostic value of liver cancer recurrence. They may applied as a predictor or indicator of postoperative recurrence of hepatocellular carcinoma.

Objective To investigate the clinical study on drynaria injection for delayed healing of fracture patients.Methods 108 patients with fracture delayed union from February 2010 to February 2016 in our hospital were selected and randomly divided into the control group and the experiment group by different treatment,54 cases in each group.The control group were treated by conventional therapy,the experiment group were treated with drynaria rhizome injection on the bases of control group.The total effective rate,serum alkaline phosphatase,NGF and BMP-2 levels were observed and compared after treatment.Results After treatment,the total effective rate of experiment group was higher than control group (P<0.05);After treatment for 7 and 14 days,the serum alkaline phosphatase level of the two groups were significantly increased (P<0.05),and compared with the control group, the serum alkaline phosphatase content of the experimental group was higher (P<0.05);After treatment for 7 and 14 days,the serum NGF and BMP-2 levels of two groups were significantly increased(P<0.05),and compared with the control group,the experimental group was higher than those in the control group.Conclusion Injection of rhizoma drynariae in the treatment of delayed healing of patients with significant effect,increase the levels of serum alkaline phosphatase, serum NGF and BMP-2,promote fracture healing in patients and improve clinical efficacy.

The purpose and meaning of epidemiology curriculum,the current problems existing in the teaching and teaching reforms for different specialties were discussed.

Objective To compare the virological responses between Peg IFNαt-2a and Peg IFNα-2b in treatment of chronic hepatitis C.Methods Clinical data of 46 chronic hepatitis C (CHC) patients were retrospectively reviewed.Patients were divided into two groups:Peg IFNα-2a group ( n =24) was given Peg IFNoα-2a 180 μg/week and ribavirin; Peg IFNα-2b group (n =22 ) was given Peg IFNα-2b1.5 μg · kg-1 · week-1 and ribavirin.Serum HCV RNA load at 4th,12th and 24th week of the treatment were detected to evaluate the virological responses.Softwares SPSS 13.0 and PEMS 3.1 were used for statistical analysis.Results There was no significant difference in rapid response rate,early response rate,complete response rate and non-response rate between the two groups (x2 =0.689,0.105,0.105 and 0.105,P ＞ 0.05 ).However for patients with high viral load ( HCV RNA ＞ 6 logl0 copies/mL) at baseline,the rapid response rate in Peg IFNα-2a group ( 86.67％ ) was higher than that in Peg IFNα-2bgroup (42.86％ ) (x2 =4.365,P ＜ 0.05 ).Conclusion Peg IFNα-2a combined with ribavirin may have higher rapid response rate than that of Peg IFNα-2b combined with ribavirin in CHC patients with high viral

Objective To understand the clinical distribution characteristics and antimicrobial resistance of pathogens causing healthcare-associated infection(HAI) in a comprehensive hospital.Methods Clinical data of patients with HAI in this hospital between May 2012 and May 2015 were collected,the distribution and antimicrobial resistance of pathogens isolated from patients were analyzed.Results A total of 6 563 cases of HAI occurred among 183 850 patients,incidence of HAI was 3.57％,445 patients were isolated at least two kinds of pathogens,375 (84.27％) patients were isolated two kinds of pathogens,132 of whom were infected with both gram negative bacilli.4 478 specimens were sent for pathogenic detection,2 503 (55.90％) of which were isolated pathogens;a total of 2 755 pathogens were isolated,including 1 713(62.18％) strains of gram-negative bacilli,732(26.57％) gram positive cocci,304(11.03％) yeast-like fungi,and 6(0.22％) anaerobic bacteria.524(19.02％)strains were mainly from patients in department of neurology.The main specimen was sputum (n =1 340,48.64％).The isolation rates of carbapenem-resistant Escherichia coli (CREC),Klebsiella pneumoniae (CRKP),Acinetobacter baumnannii (CRAB),and Pseudomonas aeruginosa (CRPA) were 0.39％ (2/510),1.66％ (3/181),59.14％ (207/ 350),and 5.29 ％ (11/208) respectively;isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 21.55％(25/116).Conclusion Multidrug-resistant organisms causing HAl are various,it is necessary to understand distribution characteristics and prevalence of pathogens,monitor multidrug-resistant organisms,and implement contact isolation measures,so as to prevent the outbreak of HAI.

Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P＜0.01),as well as in MES and PreContr between PVC-S and control subjects (P＜0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.

Objective To evaluate the appilcation value of intraoperative transesophageal echocardiography (IOTEE) in aortic valve replacement with bovine pericardium.Methods Totally 106 patients were ready to underwent the surgery of aortic valve replacement.The parameters of the aortic valves (diameter of aortic annular,aortic sinus and aortic sinus tube,effective height [eH]) were measured before cardiopulmonary by using IOTEE and during intraoperation.Results Eight cases were removed from the study due to supplemental preoperative diagnosis and modification of operative method,the rest of the 98 cases were enrolled.The coincidence rate of initial diagnosis hy using IOTEE and intraoperative diagnosis was 100 ％;5 cases (5/98,5.10 ％) of secondary diagnosis were inconsistent with intraoperative diagnosis.The coincidence rate of the number of aortic valves with preoperative IOTEE diagnosis and intraoperative diagnosis was 100 ％,the aortic valves perforation fistulas was 80.00％,the aortic valves vegetation was 85.71％,the senile calcified valvular disease was 100％,and the rheumatic disease was 100％.Diameter of aortic annular,aortic sinus and aortic sinus tube,eH measured by preoperative IOTEE had good correlation with intraoperative measurement (all r＞0.8,all P＜0.05).Conclusion IOTEE has feasibility and guiding value in aortic valve replacement with bovine pericardium,and is also of great significance to evaluate the prognosis of surgery.

Objective To investigate the clinicopathological features,immunophenotype,diagnosis and treatment of SMARCA4(BRG1)-deficient carcinoma.Methods Clinical data of 11 patients with SMAR-CA4(BRG1)-deficient cancer were collected.The morphologic and immunohistochemical features of this tumour were summarized,and the relevant literature was reviewed.Results Among the 11 cases of SMARCA4(BRG1)-deficient carcinoma,eight were male and three were female,with median age of 60.Seven patients underwent radical resection,and four underwent traditional joint targeted chemotherapy and immunotherapy.Microscopically,the tumor cells were epithelioid,rhabdoid or spindle-shaped,with prominent eosinophilic nucleoli and frequent mitoses(>5/10 HPF).Multiple foci of necrosis were found in the tumor tissue,a large number of tumor emboli in the blood vessels and myxoid stromal degeneration.Among these cases,11 cases showed loss of SMARCA4(BRG1)expression,whereas the CK and Vim markers were expressed,SMARCB1(INI1)expression was retained,and p53 mutation was detected.The tumor cells showed high proliferation activity(Ki-67>60%),and synaptophsin was moderately positive.Three cases were mismatch repair deficient and respectively showed the loss of MLH1/PMS2,PMS2 and MSH6 expression.Conclusion The incidence of SMARCA4(BRG1)-dificient carcinoma is low.It can be easily confused with other tumors and is difficult to be diagnosed before operation,which requires confirmation by immunohistochemistry.

Objective To study one male patient with cirrhosis for spironolactone induced gynecomastia and promote clinical pharmacists providing better pharmaceutical cares .Methods Based on the patient′s diseases and medication history , clinical pharmacists searched related literature and analyzed the cause of gynecomastia for the patient .Results The patient′s breast pain was relieved and finally disappeared after termination of spironolactone .Therefore ,spironolactone was suspected to be the drug to cause gynecomastia .Conclusion Clinical pharmacists can improve pharmaceutical cares by carefully monitoring the adverse reactions and selecting appropriate medications .

Objective: To analyze vaccination situation of oral live attenuated rotavirus vaccine (LLR strain) among children from six provinces in China. Methods: In 2014, we selected 12 counties in Guangdong, Jiangsu, Chongqing, Jiangxi, Heilongjiang and Gansu provinces by using stratified cluster random sampling method and extract information of children born from January 1, 2008 to December 31, 2012 from Children's Immunization Information System. We investigated ten children of each birth cohort in each county by checking the vaccination certification, and a total of 606 children were investigated. A survey was conducted to check the information of the children's vaccination certification with the data of Children's Immunization Information System by questionnaire including the basic information (province, county, name, gender, birth date, etc) and the rotavirus vaccination (vaccination date, dose, etc) to analyze the rotavirus vaccination situation. Results: 340 of 606 children were male. There were 121, 124, 122, 119 and 120 children born in 2008-2012, respectively. The proportions of the first and the second dose of rotavirus vaccination were 32.8% (199) and 9.7% (59). The proportion of the third dose of rotavirus vaccination among children born between 2008 and 2010 was 3.5% (13) since children born in 2011 and 2012 did not reach the age of third dose vaccination. The proportion of the first dose of rotavirus vaccination in high, middle and low per capita disposable income areas was 45.0% (91), 37.7% (77) and 15.5% (31) respectively (χ²= 43.15, P<0.001). Among 199 children vaccinated with the first dose of vaccine, the vaccination age mainly concentrated in 2 to 21 months, of which the peak was 5 to 13 months (66.8%, 133). The intervals between 2 doses of vaccination were mainly from 12 to 13 months (42.4%, 25) among the 59 children who received at least 2 doses of vaccine. In the 13 children vaccinated with 3 doses, the intervals between the second and the third dose were 12 months (5). Of the 271 doses of rotavirus vaccine vaccinated during 2008-2014, 34.7% (94 doses) were vaccinated in June-August, 88 were vaccinated simultaneously with 18 other vaccines, accounting for 32.5% of the total. Of the 18 other vaccines, inactivated vaccines such as diphtheria vaccine (30 doses), Hib vaccine (14 doses), group A meningitis vaccine (10 doses) were predominant. Conclusion The proportion of rotavirus vaccination was low and the vaccination age was relatively late. The vaccination mode was different from the recommendation of WHO. It is recommended that routine immunization of rotavirus vaccines should be carried out in early-months of children.