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 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

There are some problems such as the limited diseases, the shortage of teaching resources and lack of certain cases in infectious diseases teaching owing to the obvious narrowing spectrum of dis-eases and the decreasing incidence of infectious diseases, etc. We have made good progress in clinical practice teaching for medical students in infectious diseases by reforming teaching methods including enriching practice knowledge of younger teacher, collecting typical cases from hospitals in rural areas, the adjustment of teaching contents, making full use of the experience of the old professor and the advanced teaching measures in clinical practice teaching.

Tubulin is the major protein of microtubule. alpha- and beta- tubulins form heterodimers, while gamma-tubulin regulates microtubule organization. The present study aimed to observe the dynamic changes of gamma-tubulin in preimplantation development of parthenogenetic mouse embryos. Immunofluorescence and laser confocal microscopy were used to detect the location of gamma-tubulin in preimplantation parthenogenetic embryos activated by SrCl2. The oocytes were collected at 13-14 h after hCG injection, and then activated with 10 mmol/L SrCl2 in Ca(2+)-free CZB medium with 5 mmol/L cytochalasin B (CB), fixed at 1 h intervals until 6 h after activation. The results showed that spindle was paralleled with the cell membrane all the time, when the meiosis of MII mouse oocytes resumed. The rotation of spindle was inhibited, but karyokinesis was not influenced. At 0 h after activation, i.e. at metaphase, gamma-tubulin was distributed mainly on the two poles of spindle. At 1 h after activation, i.e. at anaphase, following the separation of chromosomes, gamma-tubulin was transformed from dense to disperse. At 2 h after activation, gamma-tubulin was localized between the segregated sister chromatids at telophase. However, at 3-6 h after activation, gamma-tubulin concentrated around the two female pronuclei during their formation and juxtaposition. Moreover, another group of MII oocytes were activated for 6 h and cultured in droplets of KSOM medium under mineral oil in 5% CO2 in air at 37 degrees C to permit parthenogenetic development. The embryos were collected and fixed at 3 h, 14 h, 16 h, and 18 h of culture. At 3 h after culture, i.e. at mitotic interphase, it was shown that amorphous gamma-tubulin distributed around the nuclei of early parthenogenetic embryos. At 24 h after culture, i.e. at prometaphase, gamma-tubulin migrated along the spindle microtubule to the two poles. Our results showed that gamma-tubulin had similar location patterns at metaphase, anaphase and telophase in meiosis and mitosis. It was concluded that gamma-tubulin assembly in parthenogenetically activated oocytes facilitated the formation of negative pole cap and the stabilization of microtubule, thus promoting the spindle formation at meiosis and mitosis. The relocation of gamma-tubulin at anaphase and telophase might be induced by the event of segregation of homologous chromosome being pulled away by the spindle. gamma-tubulin might contribute to the migration and juxtaposition of the two female pronuclei as well.
Animals ; Embryo, Mammalian ; Embryonic Development ; Female ; Meiosis ; Mice ; Mitosis ; Oocytes ; cytology ; Parthenogenesis ; Spindle Apparatus ; physiology ; Tubulin ; physiology

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.

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