ObjectiveTo evaluate the effect of health education to women of childbearing age on knowledge of birthdefents.MethodsRandomly selected 200 case of maternal pre-pregnancy check-up in the hospital outpatient department were divided into two groups,The observation group of 100 cases,100 cases of the control group.the control group received rule progestation knowledge education,the observation group enforce health education intervention,apply the way of questionnaire survey,and the results were statistically analyzed.ResultsThe observation group answer correct rate is obviously higher than the control group ( all P ＜ 0.05 ).ConclusionTaking a variety of measures of health education for pregnant women during the physical examination for effective interventions,could significantly improve the population birth defects knowledge rate had positive significance to the prevention of birth defects.

Objective To discuss the uhrasonography and hemodynamic characteristics of carotid atherosclerosis in elderly patients with coronary heart disease (CHD).Methods The 548 people were divided into CHD group (n = 373) and control group (n = 175) by the coronary angiography.And the patients in CHD group were sorted into myocardial infarction (MI) group (n= 160) and non-MI group (n= 213).All patients were above 60 years of age, and underwent carotid artery ultrasound examination.The data of carotid sonography and hemodynamics were classified and analyzed using SPSS 10.0 software.Results The carotid intima-media thickness (IMT), plaque thickness and score were much more in CHD group than in control group [(0.96±0.24) mm vs.(0.78±0.11) mm, (1.90±0.36) mm vs.(1.66±0.13)mm, (2.2±0.7) vs.(1.9±0.4), t= 14.81, 27.89 and 27.83, all P=0.00].A total of 161 (43.2%) patients had atherosclerotie plaques in CHD group, and there were 7 (4.0%) people with plaques in healthy control group(χ~2 =337.18, P =0.00).And there were 81.3% of patients with plaques in MI group, it was more than non-MI group, in which there were 12.9% of patients with plaques (χ~2 =60.88, P=0.00).The carotid peak systolic velocity (PSV) and resistance index (RI) were both higher in CHD group than in control group [(77.0±11.9) cm/s vs.(65.2±3.1) cm/s and 0.77±0.06 vs.0.67±0.08, (t= 12.26 and 50.43, P=0.00)].Conclusions Carotid ultrasonography could evaluate not only CHD, but also CHD severity in the elderly.

Objective To explore the effect of Shenling Baizhu power on inflammatory factors and immune function for recurrent aphthous ulcer. Methods Ninety patients with recurrent aphthous ulcer in our hospital were divided into control group and study group according to random number table method, with 45 cases each group.The control group were given oral vitamin B2, levamisole and cetyl pyridinium chloride gargle solution therapy, and the study group were given Shenling Baizhu power on the basis of control group.After one week treatment, the clinical curative effect were observed, the serum inflammatory factors levels of tumor necrosis factor alpha ( TNF-α) , interleukin 2 ( IL-2 ) and interleukin 6 ( IL-6 ) were determined by Elisa method, the levels of peripheral blood T cell subsets CD3 +, CD4 +, CD8 +and natural killer cells( NKT) were determined by flow cytometry instrument, and the recurrence rate were observed after one year follow-up.Results After one week treatment, the total effective rate 91.30% in study group was significantly higher than the control group 69.57%, the difference was statistically significant(χ2 =5.874, P=0.015).The serum levels of TNF-α, IL-2 and IL-6 in study group were significantly lower than the control group, the difference was statistically significant(P<0.05).The levels of CD3 +, CD4 +, CD8 +and NKT in study group were significantly higher than the control group, the difference was statistically significant(P<0.05).Followed up for 1 year, the recurrence rate 17.78%(8/45) in study group was significantly lower than the control group 46.67%(21/45), the difference was statistically significant(χ2 =8.598, P =0.003).Conclusion The Shenling Baizhu power treatment of recurrent aphthous ulcer has better clinical curative effect, can reduce levels of inflammatory factor, improve immune function, and reduce the recurrence rate.

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.

10.3969/j.issn.1007-3969.2013.04.010

Background and purpose:Herpes zoster is a common adverse event associated with the use of bortezomib. The objective of this study was to evaluate the efifcacy of different therapeutic regimens of valacyclovir prophylaxis: continuously administration and intermittent administration. Methods: We retrospectively analyzed the efficacy, side effects, expense of valacyclovir and emotional states of 31 patients with multiple myeloma who received bortezomib and valacyclovir prophylaxis. Among them, 14 patients underwent continuously administration of valacyclovir, the other 17 patients underwent intermittent administration. Continuously administration was deifned as daily oral valacyclovir 600 mg without cessation during entire period of bortezomib treatment. Intermittent administration was deifned as patients received valacyclovir at a dose of 600 mg daily during chemotherapy, while discontinue valacyclovir at the intermission time of bortezomib treatment. Results: There were no herpes zoster in patients of 2 arms. Adverse events over grade 3 associated with valacyclovir were not observed. Intermittent administration of valacyclovir showed a superiority of economic beneift. The emotional status were depended on the therapeutic effects of multiple myeloma. For those relapsed or refractory patients, continuously administration of valacyclovir might aggravate depression and anxiety. Conclusion:Intermittent administration of valacyclovir at a dose of 600 mg daily appears to be an effective prophylaxis for herpes zoster in patients receiving bortezomib.

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood of the inpatients in hematology ward.Methods Antimicrobial susceptibility test was carried out using Kirby-Bauer method.The data were analyzed by WHONET 5.6 software.Results Of the 521 microbial isolates collected,gram-negative bacilli accounted for 47.2％,grampositive cocci 45.7％ and fungi (7.1％).The most frequently isolated microorganisms were coagulase negative Staphylococcus (154),E.coli (88),K.pneumoniae (51),P.aeruginosa (39) and Enterococcus spp (34).ESBLs were produced in about 40.4％ of the K.pneumoniae isolates and 63.4％ of the E.coli isolates.At least 90％ of the E.coli isolates were susceptible to imipenem and meropenem,and at least 70％ susceptible to piperacillin-tazobactam.At least 85％ of the K.pneumoniae strains were susceptible to imipenem and meropenem,and at least 70％ susceptible to levofloxacin,piperacillin-tazobactam and cefoperazone-sulbactam.The percentage of the P.aeruginosa susceptible to ciprofloxacin and tobramycin was at least 90％,and higher than 70％ to levofloxacin,meropenem,imipenem,piperacillin-tazobactam,cefepime,and cefoperazone-sulbactam.More than 90％ strains of the coagulase negative Staphylococcus and Enterococcus were susceptible to linezolid and teicoplanin.Overall,82.5％ of the coagulase negative Staphylococcus isolates were resistant to methicillin.Three E.coli isolates and 4 K.pneumoniae isolates were found resistant to carbapenems,and 14 Enterococcus isolates were resistant to vancomycin.Conclusions Gram-negative bacilli are the major pathogens from blood samples in hematology ward,which show high susceptibility to piperacillin-tazobactam and cefoperazone-sulbactam,imipenem and meropenem.The grampositive cocci show high susceptibility to linezolid and teicoplanin.These data are helpful for empirical antimicrobial therapy.

Objective To analyze CT features and related factors of mediastinal lymphoma with necrosis in order to identify other mediastinal tumor with necrosis.Methods CT features were retrospectively reviewed and related factors of necrosis were analyzed in 37 cases of mediastinal lymphoma confirmed by pathology.Results 37 cases appeared as mediastinal masses,in which 25 cases were cross-regional growth of the mediastinum,1 1 cases in anterior mediastinum and 1 case in posterior mediastinum.The largest cross-sectional area of tumors was 1.6-129.6 cm2 ,in which there were 1 case (0-10)cm2 ,8 cases (10-25)cm2 ,10 cases (25-50)cm2 ,1 5 cases(50-100)cm2 and 3 cases >100 cm2 .24 cases had necrosis ,among which 23 cases were slight enhanced and 1 case was seriously enhanced.Necrosis of mediastinal lymphoma was related to the size and CT enhancement of tumor by the logistic regression analysis(P <0.05).Conclusion Mediastinal lymphoma with necrosis is common .The necrosis of mediastinal lymphoma is related to the size and CT enhancement.Slight CT enhancement is one of differential points between mediastinal lymphoma with necrosis and other mediastinal tumor.

OBJECTIVE:To investigate the efficacy and safety of carvedilol in patients with chronic heart failure(CHF). METHODS:46patients with CHF were randomly divided into carvedilol group(n=26)and control group(n=20),thareinto,standard therapeutic scheme is used in control group,standard therapeutic scheme+carvedilol is used in carve diol greup.The treatment courses were6months in both groups.RESULTS:Left ventricular end-diastolic diameter(LVEDD)reduced and left ventricular ejection fraction(LVEF)increased in carvedilol group with significant difference comparing with control group(P

Objective To explore the effect of astragalus extracts on adherence, migration, cell viability, microvascular formation, and eNOS expression in bone marrow-derived endothelial progenitor cells (EPCs) of rats. Methods EPCs were cultured, isolated and identified in vitro and divided into four groups: low titer group (10-4 g/L of astragalus extracts), middle titer group (10-3 g/L of astragalus extracts), high titer group (10-2 g/L of astragalus extracts) and control group. The effects of astragalus extract on adhesion, migration or microvascular formation were observed under the inverted microscope and com?pared between all groups;Cell viability was detected by MTT assay;mRNA transcription and protein expression levels of en?dothelial nitric oxide synthase (eNOS) in EPCs were detected by reverse transcription PCR (RT-PCR) and Western blot re?spectively. Results Compared with the control group, cell adhesion, migration and microvascular formation of EPCs all en?hanced with addition of astragalus extracts in a dose dependent manner (F=15.256, 13.633, 97.549 respectively, and P <0.05 in all cases); Cell vitality of EPCs increased with administration of astragalus extracts in a time and dose dependant manner. (F=9.755 for time and F=10.18 for dose). mRNA transcription and protein expression of eNOS in EPCs were up-reg?ulated with addition of astragalus extracts in a dose dependent manner (F=56.356 and 77.125 respectively, and P<0.05 in both cases). Conclusion Astragalus extracts play important role in angiogenesis in EPCs probably through up-regulating expressions of eNOS.