ObjectiveThe clinical features, bacteria distribution and antibiotic resistance proifle of blood stream infection(BSI) were investigated in the patients with decompensated liver cirrhosis for better management of such infections.MethodsThe clinical data of BSI were collected in the patients with decompensated liver cirrhosis between January, 2012 and December, 2014, and reviewed retrospectively in terms of risk factors, diagnosis and treatment, pathogen distribution and prognosis.ResultsOf the 1 071 patients with decompensated liver cirrhosis and suspected bacterial infection, 154 (14.4%) were diagnosed as BSI evidenced by blood culture. Of these patients, the leukocyte count in the peripheral blood was higher than 10×109/L in only 48 (31.2%) patients; neutrophil proportion>0.75 in 133 patients (86.4%); serum procalcitonin level>0.5 ng/mL in 74 patients (68.5%). A total of 155 bacterial strains were isolated, including 115 strains of gram-negative bacilli and 40 strains of gram-positive cocci. Most patients (68.8%) recovered and 31.2% died or discharged from hospital voluntarily. All these BSI patients had Child-Pugh grade C liver function. Some patients also had other serious systemic diseases or repeated hospitalization.ConclusionThe prevalence of BSI is high in the decompensated liver cirrhosis patients with poor prognosis. Gram-negative bacilli are the major pathogens of such septicemia. Early diagnosis and proper use of antibiotics based on antimicrobial susceptibility testing are important to improve patient outcome.

Due to the complicated symptoms and predictable death, patients with advanced cancer are the main group of the hospice care service. With the pain and need of physical, psychological, mental and social when death approaching, individualized strategies should be developed according to each patient's condition, to help to alleviate their pains, provide spiritual care and improve the quality of life effectively. Through the analysis of the clinical practice of hospice care for a breast cancer patient, this article summarized the nursing experience in order to provide reference for the localized hospice care.

Objective Objective To verify the accuracy of dose calculation and the precision of beam modeling in a Pinnacle three-dimension treatment planning system(TPS).Methods Based on the photon beam model data of a Varian 600C Linac,output factor verification and 12 tests were carried out ac- cording to the recommendation of Netherlands Commission on Radiation Dosimetry(NCS).The results of ion chamber measurement and TPS calculation at selected points were compared.Deviation and confidence limit were used to evaluate dose calculation accuracy.Results The Pinnacle TPS had a high precision of dose calculation when compared with the measurement data.Deviation of calculated output factors was＜1% on all opening patrols,and was＜3% on wedged portal except one with the size of 15 cm?40 cm and angled 60?.The results of 12 tests were in accordance with the criteria of NCS recommendation,with maximum av- erage deviation＜1%.The overall accuracy is better than those of other TPS reported in the literature. Conclusions Dose verification is a prerequisite before a three-dimension treatment planning system is used in the clinical practice.Pinnacle treatment planning system installed in our institute is reasonably acceptable and satisfactory.

ObjectiveTo explore the clinical characteristics of pathological fracture in extremities caused by bone tumors or tumor-like lesions. MethodsFrom August 2002 to December 2010, 139 patients with pathological fractures were entered in the study, including 79 males and 60 females with an average age of 31.1 years. Fractures included tumor-like lesion in 55 cases, benign tumor in 13, giant cell tumor (GCT)in 7, primary malignant tumors in 28, and metastatic tumors in 36. Forces induced to fractures were classified into four grades: spontaneous fracture, functional activity, minor injury, severe injury. Age, fracture location, histological results, fractures forces, prodromes, and misdiagnosis were all observed. Chi-square test were use to compare forces and prodromes within different tumors. ResultsThe highest morbidity rate is 32.4％(45/139) which lies in 11-20 years old. The cites of fractures including femurs in 71 cases, humerus in 36, tibia in 15, fingers in 7, radiuses in 4, fibula in 3, ulnas in 2, and metatarsus in 1. Fracture forces include spontaneous fractures in 29 cases, functional activity in 42, minor injuries in 65, and traumatic injuries in 3. Sixty-seven patients(48.2％) had local prodromes. The prodromes of both malignant tumors and metastatic tumors were more than benign tumors. Twenty cases experienced misdiagnosis with average delay time of 12 weeks. ConclusionMinor injury forces and local prodromes are clinical key features of pathological fractures. Both of them are key points of avoiding misdiagnosis.

OBJECTIVETo study the loss of heterozygosity (LOH) at chromosomes 1p or 19q in oligodendroglial tumors.

METHODSTwenty-eight cases of oligodendroglial tumors were enrolled into the study. Real-time quantitative polymerase chain reaction-based microsatellite analysis was performed on paraffin-embedded tumor tissues in order to study the status of chromosomes 1p and 19q.

RESULTSAmong the 28 cases of oligodendroglial tumors, 24 cases (85.7%) showed 1p LOH, while 18 cases (64.3%) showed 19q LOH and 17 cases (60.7%) showed LOH of both 1p and 19q. LOH at 1p or 19q was present in 25 (89.3%) of the 28 cases.

CONCLUSIONSReal-time quantitative polymerase chain reaction-based microsatellite analysis is a rapid and specific way in detecting LOH in paraffin-embedded tumor tissues. LOH at 1p or 19q is present in majority of the oligodendroglial tumors studied.

Adult ; Brain Neoplasms ; genetics ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 19 ; Female ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged ; Oligodendroglioma ; genetics ; Polymerase Chain Reaction ; methods

OBJECTIVE: To investigate the causes and features of medical disputes in percutaneous coronary intervention (PCI) in the cardiology and to provide references for forensic expert testimony and medical disputes prevention. METHODS: Fifty one disputed fatal cases in PCI were analyzed in terms of the cause of death, informed consent and medical operations retrospectively. RESULTS: Thirty five cases were due to medical negligence, 28 due to defect technical operation, 2 due to mistake medical management and 5 due to both defect technical operation and mistake medical management. CONCLUSION The causes of PCI medical negligence are defect medical operation, violate medical disciplines and insufficiency of informed consent.
Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cause of Death ; Coronary Artery Disease/therapy* ; Expert Testimony ; Female ; Humans ; Male ; Malpractice ; Medical Errors/statistics & numerical data* ; Middle Aged ; Myocardial Infarction/etiology* ; Postoperative Complications/etiology* ; Retrospective Studies

Aged ; Coronary Disease ; complications ; Humans ; Hypertension ; complications ; Renal Artery Obstruction ; diagnosis ; Renal Insufficiency ; complications ; Risk Factors

Objective To compare the therapeutic effect of inhaled aerosolized and intravenous milrinone (a phosphodiesteraee-3 inhibitor) on postoperative pulmonary artery hypertension (PAH) in children with congenital heart disease (CHD).Methods Forty CHD complicated with PAH children aged 5-14 yr weighing 15-38 kg with pulmonary artery pressure (PAP) 30-90 mm Hg were randomly divided into 2 groups (n = 20 each): Ⅰ milrinone inhalation group and Ⅱ intravenous milrinone group. At the end of CPB, aerosolized milrinone 1 ml/kg was inhaled for 12 h at 30 min intervals, and each time milrinone was inhaled for 10 min in group Ⅰ . In group Ⅱ , a bolus of 10 g/kg milrinone was given iv followed by 12 h milrinone infusion at 0.5 μg·kg-1 ·min-1 . Blood samples were taken from aorta and pulmonary artery for blood gas analysis at the end of administration and venous oxygen saturation (S(-v)O2) was recorded. MAP, PAP, pulmonary vascular resistance index (PVRI) and systemic vascular resistance index (SVRI) were recorded every 2 h during milrinone administration. The duration of endotracheal tube, PAH, lung infection and postoperative hyoxemia were recorded during milrinone administration. Results PAP, PVRI and the incidence of lung infection and PAH were significantly lower, while MAP, SVRI and S(-v)O2higher in group Ⅰ than in group Ⅱ (P ＜ 0.05), but there was no significant difference in the duration of endotracheal tube and incidence of hyoxemia between the two groups(P ＞ 0.05). Conclusion Inhaled aerosolized milrinone has better therapeutic effect than intravenous milrinone on PAH in children with CHD.

OBJECTIVETo understand the epidemiological characteristics of essential hypertension in the northern and western areas of China.

METHODSA community-based sampling survey.

RESULTSRates of awareness, treatment and control were 78.6%, 59.7% and 5.9%, respectively. About half of the diagnosed and treated patients took antihypertensive medicine irregularly before the survey was carried out.

CONCLUSIONIt is necessary to carry out education, prevention and control on hypertension and to establish a series of standards for the management and treatment on cases of hypertension.

Adult ; Age Factors ; Aged ; Blood Pressure ; China ; epidemiology ; Drug Administration Schedule ; Female ; Health Surveys ; Humans ; Hypertension ; epidemiology ; prevention & control ; therapy ; Male ; Middle Aged ; Risk Factors ; Social Class

The aim was to construct the expressive vector of human tissue factor (TF), and determine its expressive level in stable-transfected human ovarian cancer cell line. The human TFcDNA was obtained from human placenta by RT-PCR and then inserted into eukaryotic expressive vector pcDNA3 to obtain the TF-pcDNA3 recombinant. This recombinant gene was introduced into human ovarian cell line A2780 through transfection mediated by lipofectamine. Stable-transfected cells were screened by G418. The TF expressive levels were detected by RT-PCR and flow cytometry. The results showed that: (1) the constructed product was identified as TF-pcDNA3 recombinant by sequencing. (2) TF was highly expressed not only at transcriptional level in the stable-transfected A2780 cell (transfected cell 3.99 +/- 0.15, untransfected cell 0.97 +/- 0.23, P < 0.01), but also on the membrane of the cell surface [transfected cell (48.56 +/- 9.53)%, untransfected cell (2.73 +/- 1.15)%, P < 0.01]. It was concluded that TF gene was successfully cloned, and was introduced into human ovarian cancer cell, and the subline A2780/TF which stably expresses TF at high level was obtained. It will provide good experimental basis for investigating new mechanisms of tumor growth, invasion, metastasis, hypercoagulability, and for exploring a new strategy of gene therapy.
Animals ; Cell Line, Tumor ; Cloning, Molecular ; Female ; Humans ; Mice ; Ovarian Neoplasms ; metabolism ; pathology ; Recombinant Proteins ; biosynthesis ; Thromboplastin ; analysis ; biosynthesis ; genetics ; Transfection