Objective To explore the cause and effective management and prevention of septic shock after minimally invasive percutaneous nephrolithotomy (MPCNL) in the elderly.Methods Clinical data of 13 patients with septic shock after MPCNL in our hospital were retrospectively analyzed,and the cause,prevention and treatment of septic shock were investigated.Results The incidence of septic shock in patients undergoing MPCNL was 3.54％ in this study.Single-factor analysis and logistic regression analysis showed that the risk factors for post-MPCNL septic shock were female and the history of diabetes (both P＜0.05).Conclusions Septic shock is a serious complication after MPCNL.Intensive perioperative prevention measures can reduce the incidence of septic shock.Early diagnosis and proper treatment are the keys to successful treatment of septic shock.

Objective To evaluate the efficacy of Qingkailing injection for cerebrovascular diseases by systematic review of clinical trials. Methods Meta-analysis was used to evaluate the efficacy of Qingkailing injection on cerebrovascular diseases from 38 articles on clinical trials published from 1994 to 2008 in Chinese journals with the software RevMan5.0. Sensitivity analysis was taken to analyze the results of trails with different inclusion criteria. Results 38 clinical control trails were included for efficacy analysis, a fixed effects model was chosen and the value of odds ratio (OR) was 3.26 with the 95% confidence interval from 2.71 to 3.92. Conclusions Qingkailing injection may have positive effect on cerebrovascular diseases, its efficacy need to be confirmed with high-quality randomized controlled trials.

Blue laser imaging (BLI) is a new endoscopic system equipped with the laser beam emitting two different wavelengths.It produces bright and high resolution images for observation of microvascular and microsurface patterns of esophageal and gastric mucosa, helping the diagnosis of early upper gastrointestinal cancer.Compared with the existed endoscopic techniques, BLI shows its unique advantages.In this article, advances in application of BLI in diagnosis of early upper gastrointestinal cancer were reviewed.

0.05),but 5-Aza at the concentration of 15?mol/L inhibited the growth of MSCs(P

Objective To investigate the detection and treatment of carry-over of automatic biochemistry analyzer. Methods We detected the sample carry-over by determining one high level quality control serum and three zero levels serum continuously in five days. We used mixed patients serum to detect the carry-over come from reagent probe, muddler and cuvette by arranging test sequence of different item, combination and the times of rerun. We also used different methods such as immersion, cleaning probe, extended priming to handle the reagent carry-over.Results The sample carry-over was -0.37%～0.48% on new analyzer and 0.51～1.17% on old analyzer, respectively. The carry-over of CHO, TG, HDL on reagent probe and muddler of TBA was 86.9%～208.7% and 86.0%～256.5% on old analyzer, respectively. There was no reagent carry-over among other items on old analyzer. There was no carry-over on reagent probe on new analyzer, the carry-over of different items on cuvette of TBA was -0.9%～1.7%. After immersion, cleaning and extended priming, the carry-over of CHD, TG, HDL on TBA reagent probe fell to -1.1%～2.7% and -0.07%～0.09%, respectively.Conclusions The methods which have been mentioned above can detect the sample and reagent carry-over. The carry-over can be reduced by immersion, cleaning, extended priming and testing in different unit.

OBJECTIVE To establish a rapid detecting method for Clostridium perfringens on traumatic tissues by type-specific multiplex PCR.METHODS Established a simple and rapid method(TLS method) for purifying the DNA of genomes and plasmids in standard strains of C.perfringens wild strains on surface of open traumatic tissues and detected DNAs by type-specific multiplex PCR.RESULTS All types of C.perfringens could be detected by type-specific multiplex PCR.The sensitivity by PCR for type A of C.perfringens arrived at 7.5?103/ml and a whole run could finish within 5 h;the results by PCR entirely corresponded with those by cultureing.CONCLUSIONS New methods for purifying DNA of genomes and plasmids of C.perfringens are simple and rapid;there are high specificity and sensitivity for detecting DNA by multiplex PCR within short time,which can be practiced in clinical laboratory.

Objective To explore the role of forkhead box protein O3a (FOXO3a) in inhibiting the proliferation and metastasis of breast cancer cells by downregulation of vascular endothelial growth factorA (VEGF-A).Methods Cell proliferation bioassay and plate clone formation assay were used to compare the changes of proliferation after siRNA interference.Wound healing and Transwell were used to compare the changes of invasion metastasis after interference.Meanwhile,the changes of VEGF-A expression in the cells before and after interference were compared by real time polymerase chain reaction (RT-PCR) and Western blot.Furthermore,the expressions of mRNA FOXO3a and VEGF-A were detected in 20 cases of breast cancer patients in breast cancer tissues and adjacent normal breast tissues.Results The MCF-7 and MDA-MB-231 cells were increased in cell proliferation and invasion after interference.Further studies found that mRNA and protein expression of VEGF-A were up-regulated in MCF-7 and MDA-MB-231cells after interference.In vivo the expression of FOXO3a was lower in 15 cases of cancer compared to normal tissues,and the expression of VEGF-A was high in 15 cases of cancer (75％).FOXO3a and VEGF-A expression was highly negatively correlated.Conclusions This study showed that FOXO3a could inhibit the proliferation and invasion of breast cancer cells,which might be regulated by VEGF-A.It provides an important theoretical evidence for targeted inhibition of breast cancer metastasis.

In recent ten years, general practitioner (GP) training and practice develops rapidly in China. It has established a relatively complete GP training system, including medical college education and standardized residency training. However, the path of continuing professional development and clinical skills improvement for GP after standardized residency training is still unclear. The concept of GP with special interest (GPSI) has been proposed these days, and it has put forward a new development direction for the career path of GP. In this article, on the basis of understanding the current status of GPSI in China, we try to discuss its advantages and problems, and then propose our suggestions for its future development.

Objective To better promote the health education and health promotion among patients with chronic disease, general practitioners (GPs) in the community should master the knowledge of non-communicable diseases (NCDs). This paper aimed to describe the current situation of GPs' knowledge about prevention and treatment of NCDs. Methods Self-designed questionnaires were issued to 1 077 GPs in community health service centers, and all GPs finished the questionnaire without assistance. The content of questionnaire includes the general information of GPs and six questions focusing on NCDs. Results Overall, 1 076 GPs completed the questionnaire, and the response rate was 99.9% (1 076/1 077). With regard to the six questions about NCDs, 90.4% (973/1 076) of GPs were well aware of the diagnosis of hypertension. Apart from that, the knowledge of diabetes mellitus (60.9%, 655/1 076), factors related to NCDs (70.2%, 755/1 076), the concepts of mental illness (52.0%, 560/1 076) and the clinical significance of tumor markers (87.9%, 946/1 076) among GPs were adequate, while more than half of the GPs did not know a lot about home oxygen therapy. Conclusion The mastering level of knowledge about prevention and treatment of NCDs among GPs varies that they need further improvement.

This study was aimed to establish a fast determination method of main components in honey. Honey samples from difference production bases were used as study objects. Transmission and reflection spectra of different honey samples were collected with the Fourier transform near infrared spectrometer. The main components in honey (moisture content, fructose content, glucose content and reducing sugar content) were detected by the near infrared quantitative analysis technique. The near infrared quantitative analysis models of moisture content, fructose content, glucose content and reducing sugar content in honey were established by the partial least squares (PLS). The results showed that the correlation coefficient (r) of the moisture content, fructose content, glucose content and reducing sugar content in honey were 0.997 25, 0.973 90, 0.927 94 and 0.952 68, respectively. The root mean square error of prediction (RMSEP) were 0.165 (%), 0.564 (%), 1.300 (%) and 1.270 (%), respectively. It was concluded that determination of main components in honey by the near-infrared spectroscopy technology was a fast and nondestructive determination method with high accuracy, which can be used in the quantitative detection of main components in honey.