Difficult cases are frequently found at the department of internal medicine of large hospitals.Better quality of ward-rounds by these department heads is key to medical safety,to better operations,and to reducing medical disputes incurred by malpractice.Focusing on standardizing wardround behavior and medical records,the People's Liberation Army General Hospital established and applied the Quality Standards of Ward-rounds on difficulty cases,which scored expected outcomes of better quality of care and better patient satisfaction.

Objective: To investigate the expressions of Fas, FasL in papillary adenocarcinoma of thyroid gland tissues and their tumor infiltrating lymphocytes(TIL), and its relationship with apoptosis and Fas, FasL in thyroid tumors.Methods: We detected the apoptotic rate and the expression of apoptotic related gene Fas in 43 cases of papliiary adenocarcinoma of thyroid gland with flow cytometry. The expression Fas and FasL were measured in 43 cases of papillary adenocarcinoma of thyroid gland, 28 cases of thyroid adenoma,43 paplillary adenocarcinoma of thyroid gland TIL,17 thyroid adenoma TIL using flow cytometry.Results: 19 cases in papillary adenocarcinoma showed low expression of Fas protein with an average apoptotic rate of 3.71% and 24 cases had high expression of Fas with an apoptotic rate of 7 26%(P

The 13 nm gold nanoparticles ( AuNPs ) were synthesized through the reduction of HAuCl4 by sodium citrate and the glutathione was assembled on the AuNPs. Under the experiment conditions, glutathione-modified AuNPs ( GSH-AuNPs ) with negative charge presented a wine red color owing to the electrostatic repulsion between nanoparticals. Upon the addition of neurogenin 3 ( ngn3 ) peptide, the aggregation of GSH-AuNPs was induced by ngn3 peptide under a certain concentration of salt. The color of AuNPs solution changed from red to blue as a function of the ngn3 peptide concentration. Thus, a rapid detection method for ngn3 peptide using GSH-AuNPs as colorimetric probe was established. The optimal experiment conditions were equilibrium time=10 min, pH=6. 0, CNaCl=100 mmol/L. Under the optimum conditions, the assay showed a linear response range of 20-300 μg/L for the peptide with a detection limit being 8 μg/L and exhibited excellent selectivity for ngn3 peptide.

Objective To investigate the effects of rhubarb and mirabilite and compound danshen injection on gastrointestinal dysmotility of severe acute pancreatitis (SAP). Methods Forty-one SAP patients were randomly divided into two groups: Integration group (n=21) were treated with rhubarb and mirabilite and compound danshen injection. Control group (n=20) were treated with conventional therapy. Recovery of gastrointestinal motility of two groups was observed, and the complication rate and hospital stay was recorded.Results The recovery of gastrointestinal motility, first defecation and hospital stay in integration group was (3.1±0.8)d, (3.1±0.8)d, (21.5±2.8 )d, which were significantly shorter than those in control group [(5.2±1.4) d, (4.7±1.3 ) d, (32.1±3.60) d, P ＜ 0. 05 or P ＜ 0.01. Five patients in integration group developed complication, which was significantly lower than 8 patients in control group ( P ＜ 0.01 )]. One patient died and one patient received operation in integration group, and one patient died in control group,without significant difference between the two groups (P ＞ 0.05 ). Conclusions The combination of rhubarb and mirabilite and compound danshen injection in severe acute pancreatitis can promote the recovery of gastrointestinal motility.

Abstract: Molecular genetic map is a fundamental organizational tool for genomic research. However, a genetic linkage map for Bupleurum chinense DC. has not been developed. In this study, with the theory of pseudo-testcross, 96 F1 plants from an intraspecific cross of B. chinense were used as mapping populations. Twenty eight ISSR (inter-simple sequence repeat) primers and 44 SSR (simple sequence repeat) primers were used to detect the polymorphisms between the parental plants, and of them, 28 ISSRs and 14 SSRs were selected to analyze the F1 populations. The map consisted of 13 linkage groups which included 80 (72 ISSRs and 8 SSRs) loci, and covered 2 633.9 cM with an average density of 33.4 cM. All 13 linkage groups consisted of 2-31 loci ranging in length from 15.4-1295.7 cM. This map will provide a basis for studies on gene mapping, map-based cloning and maker-assisted selection of important traits in B. chinense.

Objective To compare HER-2 state in breast cancer tissue deteced by fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) and analyze their correlation. Methods HER-2/neu protein expression and gene amplification were detected by FISH and IHC in 56 newly-diagnosed cases of female breast cancer from July 2008 to July 2009. Results Of the 56 patients, HER-2 protein expression (-), (+), (++), (+++) was 9 cases (16.1%), 29 cases (51.8%), 11 cases (19.6%) and 7cases (12.5%) respectively; 26 cases (46.4%) had HER-2 gene amplification while 30 cases (53.6%) didnt have. Type of HER-2 gene amplification was mainly HER-2(++) and HER-2(+++), and according gene amplification rate was 72 7% and 100%. HER-2 (+) gene amplification rate was 37.9 %(11cases) and no gene amplification was found in HER-2(-) tissue. The HER-2 positive rate using two methods had significant difference(χ2=19.778,P<0.01). HER-2(-) and HER-2(+++) had good consistency with the FISH results(Kappa=0.969),but HER-2(+) and HER-2(+ +) were poorly consistent with the FISH results(Kappa=0.271). Conclusions IHC is the preliminary screening method for detection of HER-2 expression. HER-2(-) and HER-2(+++) have good consistency with the gene amplification, and can guide clinical treatment. Some patients with HER-2(+) and HER-2(++) have HER-2 gene amplification. FISH is needed for targeted therapy.

The article reviewed the effects of resistance training,aerobic exercise in patients with diabetes and pre-diabetes,based on the metabolic characteristics in patients with pre-diabetes,and aimed at providing theoretical reference for exercise in the prevention and control of diabetes mellitus.

Objective To estimate the averaged excess relative risk(ERR) in Chinese population based on the radiogenic cancer risk of leukemia in Japanese atomic bomb survivor cohort,and to discuss proper method suitable for risk transfer between populations.Methods Based on BEIR Ⅶ radiogenic cancer model and population transfer model,and the 2009 Chinese leukemia baseline rates given in 2012 Chinese Cancer Registry Annual Report,comparison was made of population incidences in seveal countries to adjust the weighting factors.Results The ERR of three subtypes of leukemia as a whole was obtained,and the weighting factors for risk transfer model was assumed.The additive factor for male was 0.2,and the multiplicative factor was 0.8,while the additive factor for female was 0.15,and the multiplicative factor was 0.85.Conclusions For the risk transfer between populations,weighting factor was adjusted as a whole to obtain the ERR value for estimating the risk to Chinese population.The risk transfer method suitable for Chinese population was obtained by using the incidence rate available for Chinese population to directly transfer radiation-induced leukemia risk to Chinese from Japanese.

Objective To investigate the effect of nitric oxide synthase(NOS) inhibitors and L-arginine(L-Arg) on the prognosis of traumatic shock in rats. Methods Traumatic shock models of Sprague-Daulay rats were made and randomly devided into control group (n=24),L-NAME treatment group (n=24),AG treatment group (n=24) and L-Arg treatment group (n=24). Serum nitric oxide(NO) levels and oxygen partial pressure in tissues include skeletal muscles,liver and small intestine were detected at 1h,3h,5h after resuscitation. Meanwhile, hemodynamic data of the rats and their survival rates of 12h and 24h were monitored and recorded. Results Serum NO concentration was statistically lower after resuscitation in L-NAME group than that in control group, while there were no statistical significance of tissues oxygen partial pressure and survival rate in 12、24h between the two groups. AG could decrease serum NO levels only at late stage of traumatic shock,but no effect on the synthesis and relase of NO at early stage of traumati shock.AG could improve tissues oxygen partial pressure of the liver and small intestine, and prolonged the mean survival time. L-Arg could increase serum NO levels, and improve oxygen partial pressure of intestine and significantly increase the survival rate at 12h and 24h in rats with traumatic shock. Conclusions Treatment with AG and L-Arg can improve the prognosis of traumatic shock rats much better than that with L-NAME.

Objective To explore surgical approach for internal mammary node biopsy in patients with breast cancer. Methods Modified radical mastectomy and incised intercostal muscles for internal mammary node biopsy was performed on 113 patients. The distance from the internal mammary artery to the lateral sternal border, and the intercostal distance between the two costal cartilage were measured. Anatomical location and maximal diameter of the excised nodes were recorded. Results The internal mammary artery runs through intercostal space along the lateral sternal border. The distance from the internal mammary artery to the lateral sternal border was (10. 9?4. 5) mm, (11.6?2.9) mm, (9.6?3.6) mm and (4.5?3.5) mm in the first, second, third and fourth intercostal space, respectively. The distance between the two costal cartilage was (14. 2?4. 1) mm, (16. 2?4. 2) mm, (13. 9?4. 3) mm and (9.9?3. 6) mm in the first,second, third and fourth intercostal space, respectively. Two hundred and seventy-nine internal mammary nodes were excised from 113 patients. The anatomical location of the internal mammary nodes which embedded in the fatty tissue surrounding internal mammary artery were 41. 2% at the medial side, 51. 6% at the lateral side and 7. 2% in an anterior plane to the internal mammary artery. Metastases in the internal mammary node were detected in 26 patients. The lymph nodes metastasis were detected only in the internal mammary nodes in 5 cases. Conclusion Internal mammary node biopsy via intercostal space is a feasible, minimally traumatic, low-risk procedure.