Duchenne muscular dystrophy(DMD)is a fatal muscular wasting disease in children.Because of various factors such as DMDˊs low incidence,quick progression,limited knowledge of this disease,and treat-ment outcomes of respiratory failure,heart failure has become the leading cause of death in these patients.Early diagnosis and treatment is essential for prolonging the survival time and improving the quality of life.This review describes recent progress in the study of epidemiology,pathogenesis,early diagnosis,prevention and treatment of cardiac injury in patients with DMD.

Objective: To investigate the efficacy of mifepristone in patients with Cushing's syndrome and the incidence of adverse reactions to provide basis for its clinical use.Methods: One case of Cushing's syndrome treated with mifepristone participated by pharmacist was analyzed.Results: Mifepristone could significantly improve hyperlipidemia and the complications of the patient, meanwhile, the risk of hypoglycemia should be paid attention and insulin therapy should be withdrawn timely.Conclusion: Mifepristone can significantly reduce blood glucose levels and improve the appearance of Cushing.At the same time, the level of serum potassium needs close monitoring to avoid the occurrence of hypokalemia.

Objective To analyze the relationship between blood glucose level, blood pressure and weight with pancreatic cancer genesis. Then to explore the metabolism associated risk factors in pancreatic cancer genesis. Methods Form December 2002 to September 2009 in Ruijin Hospital, 548 pancreatic cancers with pathology diagnosis after pancreatectomy were collected for the study with retrospective analysis method. The association of pancreatic cancer with blood glucose level, blood pressure, weight and other metabolic factors were analyzed. Results With principal component analysis, it suggested that there were strong correlation between blood glucose level, blood pressure and weight index (BMI) increasing with pancreatic cancer. The contribution rates were 3. 614%,25. 236%, 15. 418% and 12. 918%, respectively. Single factor analysis indicated that the association between pancreatic cancers and new onset diabetes mellitus (duration≤ 2 years) was stronger than that of long-term diabetes mellitus. The occurrence rate of pancreatic cancer in patients with long-term diabetes whose blood glucose level was not well controlled recently while well controlled previously (44.6 % ) was significant hister than that in patients without diabetes (5. 6% , P＜0.05). The fasting blood glucose level of these PC patients ( 13.87± 3. 49 mmol/L) was significantly higher than new onset and other long-term diabetes patients, the comparative risk was 13.46 (95% CI 4. 560,39. 731). BMI increasing was a risk factor of pancreatic cancer, but there was no significant statistical difference between risk degree and BMI increasing level. All above metabolic diseases were risk factors of pancreatic cancer, but for pathology, location and stage of pancreatic cancer there was no statistical difference in theses factors. Conclusion This study suggested diabetes, BMI increasing and hypertension were high risk factors of pancreatic cancer genesis. New onset and long-term diabetes patients whose blood glucose not controlled well recently should be watched carefully for pancreatic cancer. Early treatment and intensive follow-up of metabolic disease might be helpful to early diagnosis and prognosis of pancreatic cancer.

Evolutionary psychology holds such an opinion that negative situation may threaten survival, trigger avoidance motive and have poor effects on the human-body function and the psychological quality. Both disgusted and sad situations can induce negative emotions. However, differences between the two situations on attention capture and emotion cognition during the emotion induction are still not well known. Typical disgusted and sad situation images were used in the present study to induce two negative emotions, and 15 young students (7 males and 8 females, aged 27 ± 3) were recruited in the experiments. Electroencephalogram of 32 leads was recorded when the subjects were viewing situation images, and event-related potentials (ERP) of all leads were obtained for future analysis. Paired sample t tests were carried out on two ERP signals separately induced by disgusted and sad situation images to get time quantum with significant statistical differences between the two ERP signals. Root-mean-square deviations of two ERP signals during each time quantum were calculated and the brain topographic map based on root-mean-square deviations was drawn to display differences of two ERP signals in spatial. Results showed that differences of ERP signals induced by disgusted and sad situation images were mainly manifested in T1 (120-450 ms) early and T2 (800-1,000 ms) later. During the period of T1, the occipital lobe reflecting attention capture was activated by both disgusted and sad situation images, but the prefrontal cortex reflecting emotion sense was activated only by disgusted situation images. During the period of T2, the prefrontal cortex was activated by both disgusted and sad situation images. However, the parietal lobe was activated only by disgusted situation images, which showed stronger emotional perception. The research results would have enlightenment to deepen understanding of negative emotion and to exploredeep cognitive neuroscience mechanisms of negative emotion induction.
Adult ; Attention ; Brain Mapping ; Cognition ; Electroencephalography ; Emotions ; Evoked Potentials ; Female ; Humans ; Male ; Occipital Lobe ; physiology ; Parietal Lobe ; physiology ; Prefrontal Cortex ; physiology

Objective To investigate the direct economic losses caused by healthcare-associated infection(HAI)in patients with acute lymphoblastic leukemia (ALL)and acute non-lymphoblastic leukemia (ANLL).Methods All acute leukemia (AL)adult patients who were admitted to a hematology ward in a hospital between January 201 1 and December 2013 were included in the study,HAI group(case group)and non-HAI group (control group),ALL group and ANLL group were matched respectively in a 1:1 ratio,hospitalization expenses and length of hospital stay were compared.Results A total of 994 patients were included,166 were with ALL,828 with ANLL,there were 181 pairs of case group and control group,and 15 pairs of ALL group and ANLL group. Direct economic los-ses in ALL group and ANLL group were 13 089.0 ￥ and 21 565.0 ￥ respectively ;extension of length of hospital stay due to HAI were 10.5 and 10.0 days respectively,differences were statistically significant between case group and control group (both P<0.05). The total hospitalization expense,as well as fees for bed,consultation,treat-ment,laboratory examination,nursing,medicine,traditional Chinese medicine,and blood transfusion in ANLL group were all higher than ALL group,but there were no significant difference.Conclusion HAI in patients with AL can increase hospitalization cost and prolong length of hospital stay.

Objective To investigate the economic losses in kidney transplant patients with healthcare-associated lower respiratory tract infection(LRTI).Methods All transplant patients in a hospital from 2008 to 2012 were in-vestigated,patients with LRTI were in infection group(n=45),and patients without LRTI were in control group(n=266),hospitalization expenses and hospitalization days between two groups were compared.Results A total of 383 kidney transplant patients were included in the study,the incidence of LRTI was 11 .75% (n=45),median ex-pense of infection group and control group was ￥79 291 .82 and ￥72 185.14 respectively,the difference was not statistically significant (P >0.05).The largest increased expense in patients with LRTI was medicine (increased by￥5 429.82),medicine and examination expense in infection group were significantly higher than control group (￥39 123.17 vs ￥33 693.35;￥702.52 vs ￥593.73;P <0.05 ).The median hospitalization days in infection group and control group was 28.38 days and 21 .47 days respectively,there was significant difference between two groups(P <0.05 ).Conclusion Kidney transplant patients with LRTI suffer from a heavy financial burden,and their hospitalization days are prolonged,so measures should be taken to prevent the occurrence of LRTI and save limited medical resources.

Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.

OBJECTIVE:To study the resistance of methicillin-resistant Staphylococcus aureus(MRSA) and detect its Panton-Valentine leukocidin (PVL) gene. METHODS:45 strains of MRSA were clinically isolated from the patients in The First Hospital of Hebei Medical University from January 2007 to June 2008. The susceptibility of the MRSA strains to 17 kinds of antibiotics was tested by Kerby-Bauer disk diffusion test,and the PVL gene was detected by polymerase chain reaction(PCR) technology. RESULTS:The resistant rates of the 45 strains of MRSA to penicillin G,erythromycin,clindamycin,ciprofloxacin and tetracycline were all above 70%. PVL genes were found in 12 of the total 45 MRSA strains,with a detection rate of 26.7%. CONCLUSION:MRSA shows multi-drug resistance,and PVL gene is a key causative agent of MRSA.

Objective To explore the effect of action research based on group learning in hospice care module for nursing students. Methods 82 students were divided into cooperative learning group (40) and conventional teaching group (42). The cognition and attitude of good death questionnaire was used to evaluate teaching effect before and after teaching of hospice care. After teaching, self-feedback and self-feedback questionnaire were made to evaluate the effect of cooperative learning group. SPSS 17 was used to make comparison of data between groups and within groups, and t test, chi square test or Fisher exact probability 2 were also used . Results There were no difference between two groups of nurses before teaching. The students' cognitive level and attitude in cooperative learning group increased significantly, especially their cognitive level of physiological needs (t=5.398, P=0.001), cognition and attitude of death education in intervention group was higher than control group (t=2.992, P=0.004; t=3.661, P=0.001). Although 95% of the nursing students of the cooperative learning group thought group cooperative studying could improve their interests and cultivated their comprehensive abilities, only 50% could accept this kind of studying methods . Conclusions Action research based on group cooperative studying can improve students' cognitive level and attitude of good death, and it is also good for cultivating their ability of au-tonomous learning, innovation, cooperation, and meanwhile, educational action research is a good way to improve both teaching effect and research ability of teacher staffs, but in practice, students' acceptance of group learning needs to be improved.

Objective To investigate the prognostic value of decreased vasopressin (VP)modulation in the late-phase of septic shock. Methods A prospective study was conducted. Fifty-five septic shock patients hospitalized in intensive care unit (ICU)of the First Hospital of Hebei Medical University from January 2012 to February 2014 were enrolled. All patients received 3% hypertonic saline solution infusion. Serum concentrations of sodium and VP were measured before and after hypertonic saline solution infusion. Patients with ratio of difference in sodium and VP before and after infusion of 3%hypertonic saline (△VP/△Na)≤0.5 pg/mmol were defined as non-responders,and who>0.5 pg/mmol were defined as responders. The levels of lactic acid,C-reactive protein (CRP),and vasoactive drug〔dopamine(DA)and norepinephrine(NE)〕usage between the two groups were compared. The 28-day mortality,live time in the dead,and ICU day in survivors were analyzed between the two groups. The receiver operating characteristic curve (ROC curve)was drawn to assess prognostic value of VP. Results There were 30 cases (54.5%) in non-responsive group,and 25 (45.5%)in responsive group. There were no significant differences in the age,acute physiology and chronic health evaluationⅡ (APACHEⅡ)score,central venous pressure (CVP),blood pressure, plasma albumin level,sodium level before and after hypertonic saline solution infusion between the two groups. The baseline level of VP in the non-responsive group was markedly lower than that of the responsive group (ng/L:10.66± 1.57 vs. 17.13 ±5.12,t=6.091,P<0.001). After hypertonic saline solution infusion,the VP level was also significantly decreased compared with that in the responsive group(ng/L:11.65±1.74 vs. 22.50±5.31,t=9.758,P<0.001). The non-responders showed higher lactic acid (mmol/L:3.04±0.55 vs. 2.28±0.38,t=-5.881,P<0.001) and CRP (mg/L:117.9±23.0 vs. 94.9±17.0,t=-4.143,P<0.001),and received larger dosage of vasoactive drugs〔DA(μg·kg-1·min-1):14.8±3.9 vs. 8.9±1.6,t=-5.725,P<0.001;NE(μg·kg-1·min-1):0.96±0.42 vs. 0.40± 0.09,t=-5.625,P<0.001〕for maintaining blood pressure compared with those in responders. The non-responsive group showed higher 28-day mortality(66.7%vs. 40.0%,χ2=3.911,P=0.048)and longer ICU day(days:9.9±2.3 vs. 6.7±1.7,t=-4.044,P<0.001),but the live time in the dead showed no difference between non-responsive group and responsive group(days:5.8±1.9 vs. 6.1±2.3,t=0.384,P=0.704). ROC curve showed that the area under ROC curve(AUC)forΔVP/ΔNa predicting the outcome was 0.828,and theΔVP/ΔNa threshold value of 0.5 pg/mmol had the sensitivity of 66.7%and specificity of 64.0%for prediction of the outcome(95%confidence interval:0.722-0.934). Conclusion Osmotic pressure-regulated VP secretion was impaired and decreased in the late-phase of septic shock, and made the sense in prognosis.