Objective To investigate the clinical effectiveness of fast track surgery ( FTS) nursing during laparoscopic cone-shaped resection of renal tumor. Methods Forty patients who was planned to accept laparoscopic cone-shaped renal tumor resection was divided into either FTS group ( n=20 ) or control group ( n=20 ) according to odd-even number of their admission IDs. The control group was given routine perioperative nursing procedure, and the FTS group was given FTS nursing. Results The operation time, intraoperative blood loss and incidence of complications had no statistical significance between the two groups (P>0. 05). As compared to the control group, patients in the FTS group experienced a shorter anal exhaust time [(30. 3 ± 11. 7) h vs. (43. 0 ± 15. 5) h, t= -2. 924, P=0. 006], shorter post-operative fasting time [(26. 6 ± 12. 1) h vs. (56. 1 ± 18. 1) h, t= -6. 059, P=0. 000], earlier ambulation [(33. 6 ± 16. 8) h vs. (66. 9 ± 28. 6) h, t= -4. 490, P=0. 000], shorter urethral catheterization [(40. 2 ± 18. 5) h vs. (83. 4 ± 39. 6) h, t= -4. 420, P=0. 000], shorter drainage time [(50. 3 ± 22. 5) h vs. (102. 9 ± 46. 0) h, t= -4. 594, P=0. 000], and shorter length of hospitalization [(5. 5 ± 1. 5) d vs. (9. 0 ± 2. 1) d, t= -5. 911, P=0. 000]. Conclusions FTS nursing procedure can reduce the rate of post-operative complications and shorten hospitalization stay. It can not only guarantee the efficacy of surgical treatment but also help the patient to achieve the goal of fast rehabilitation, being worthy of extensive application.

Objective To understand the causes and the ratio of cause constituents in children with chronic cough in Beijing. Methods Patients with chronic cough treated at respiratory clinic of the Children' s Hospital Affiliated to Capital Institute of Pediatrics from May 2009 to April 2011 were included in this study. Etiologic diagnostic procedure suggested for children by the Subspecialty Group of Respiratory Diseases,the Society of Pediatrics,Chinese Medical Association in 2008 was implemented to manage the patients. After three - month follow - up,the etiological data was analyzed. Results Totally 213 patients with chronic cough aged 1. 1 to 14. 0 years old were enrolled,inclu-ding 40 cases(18. 8% )aged≤3 years old,134 cases(62. 9% )aged ﹥ 3 to 6 years old,and 39 cases(18. 3% ) aged ﹥ 6 years old. The majority of patients with positive allergen tests were sensitized to inhaled allergens. One child had positive result in 24 - hour esophageal pH monitoring,but his cough didn't respond well to the specific treatment for gastroesophageal reflux,so he wasn't diagnosed as gastroesophageal reflux cough. The 4 leading causes of the 213 pa-tients with chronic cough were cough variant asthma(CVA)in 92 cases(43. 2% ),CVA associated with upper airway cough syndrome(UACS)in 57 cases(26. 8% ),UACS in 28 cases(13. 2% ),respiratory infection and post - infec-tion cough(PIC)in 26 cases(12. 2% ),while other causes were found in 8 cases(3. 7% ),and unknown etiology in 2 cases(0. 9% ). The incidence of CVA ranked top 1 in all the 3 age groups,followed by PIC in ≤3 years old group, while CVA associated with UACS in the other 2 age groups. Conclusions CVA,CVA associated with UACS,UACS and PIC were the 4 leading causes for children with chronic cough in Beijing. Children in different age groups had dif-ferent constituents ratio of causes of chronic cough.

Objective To explore the resistance and molecular mechanisms underlying the anticancer activity of daunorubicin in CD34 +acute myeloid leukemia(AML) cells. Methods CD34 +AML cell lines(KG1a and Kasu-mi-1)were used as objectives, and CD34 -AML cell line U937 was used as positive control. Western blot analysis was used to examine the protein expression of Bcl-2 and Bax in CD34 +AML and CD34 -AML cell lines incubated with/without daunorubicin to compare the sensitivity of CD34 +AML and CD34 -AML cells to daunorubicin. SiRNA against Bcl-2 was used in KG1a and Kasumi-1 cells and examined the effect on cell viability by MTT assay. Results Western blot analysis showed that Bcl-2 protein levels in CD34 +AML cells appeared to be significantly higher than in CD34 -AML cells. Western blot analysis showed that treatment with 0.4 μg/ml daunorubicin for 48 h caused down-regulation of Bcl-2 only in CD34 -AML cells,but not in CD34 +AML cells. Suppression of Bcl-2 with siRNA increased the susceptibility of KG1a and Kasumi-1 to daunorubicin. Conclusion CD34 +AML cell lines ex-press higher levels of Bcl-2 protein. Daunorubicin fails to down-regulate the high Bcl-2 protein levels in CD34 +AML cells. Suppression of Bcl-2 with siRNA increases the susceptibility of KG1a and Kasumi-1 to daunorubicin. The high Bcl-2 protein levels in CD34 +AML cells may be involved in the insensitivity to daunorubicin.

Objective To report the diagnosis and treatment of an imported case of schistosomiasis haematobium,including the pathological features of the disease and therapeutic efficacy of praziquantel. Methods The data of the patient with schistoso?miasis haematobium were collected,and the pathological features of the bladder tissue were observed under a microscope. More?over,the patient was treated with praziquantel,and his urine was collected before and after the treatment. The eggs in the urine were examined by a microscope after sediment and the miracidia were hatched. Results The patient once worked in Angola for three months,and after returning home he had the symptoms of intermittent painless terminal hematuresis. It was ineffective af?ter anti?inflammatory treatment in a number of hospitals. There were no sand spots discovered under the cystoscope. However , the inflammatory reaction to parasite with a lot of eosinophils infiltration in the bladder mucosa was found on the pathological sec?tions under a microscope,and the egg structure was observed with individual characteristics. The eggs were detected in the urine and the miracidia were hatched before the praziquantel treatment. The hematuria symptoms disappeared after the praziquantel treatment. The eggs were still detected in the urine 7 days post?treatment,but the miracidium could not be hatched. One month and 6 months post?treatment,the eggs were not detected in the urine. Conclusions The imported cases of schistosomiasis hae?matobium are often misdiagnosed,and therefore,it is necessary to strength the health education to the workers overseas and also to improve the ability of diagnosis in medical staff. For the case reported in this paper,there are typical structure of Schistosoma haematobium eggs and egg?granulomas on the pathological sections of bladder tissues. Praziquantel has satisfactory treatment re?sults.

Objective To observe the effects of puromycin aminonucleoside (PAN) and dexamethasone (DEX) on the expression and distribution of pedocin in vitro, and to explore the possible mechanism of DEX in improving proteinuria. Methods Mouse podecyte cells (MPCs) in control group were cultured with RPMI-1640 plus 0.02% DMSO, and were subjected to PAN treatment alone (PAN group) or PAN plus DEX (DEX group) for 8, 24,48 hours respectively. The pedocyte morphology was observed by phase-contrast microscope, and was analyzed by Image J. The distribution, mRNA and protein expression of podocin were detected by indirect immunocytofluorescence, semi-quantitative RT-PCR and Western blot, respectively. Results The well-developed arborization and interconnection of podocytes were found in control group. PAN treatment led to significant shrinkage of pedocytes with decreased distribution at 43% of control group at 8 h, 10% at 24 h and 5.7% at 48 h (P<0.01), respectively, together with podocyte foot process retraction as well as effacement and loss of cell contact. RT-PCR revealed podoein mRNA expression prone to decrease. Western blot showed podoein protein expression was significantly decreased and immunocytochemistry revealed podoein expression was disappeared in the cellular membrane after PAN treatment. DEX significantly prevented the shrinkage of podcytes, with decreased area at 43.9% of control at 8 h, 26.2% at 24 h and 29.6% at 48 h (P<0.05), respectively, and up-regulated the mRNA and protein expression of podocin at 48 h (P<0.05). The abnormal distribution of podocin was also alleviated by DEX. Conclusion DEX exerts a direct action on podocyte via stabilizing mRNA, protein expression and distribution of podocin, which may be associated with the improvement of proteinuria.

Objective To provide the basis for the differentiation with similar species of intestinal flukes through observing the figure of Haplorchis pumilio. Methods Adults of H. pumilio were collected from the intestine of the cat which was infected with the encysted cercariae of H.pumilio for 45 days. The worms were observed after staining. Eggs and metacercariae of H.pumilio were collected and examined for their shape, size and morphological characteristics. Pseudorasbora parva, the fish host, was examined for the parasitized sites of metacercariae. Results The principal characteristics of the adults is the acetabulum degradation. There are only the genital sucker with 44-48 hamuli. The average measurement of eggs is 31.2?16.7 ?m with a smooth shell. Its aceromion is not evident. The average diameter of metacercariae is 168.5 ?m. There are squamous spines on metacercaria. The metacercariae only parasitize in the muscle between the basis of the fin and the fish body. The average measurement of metacercaria cyst is 445?95?m, with squamous spines on the body surface. Hamuli are found on the genital sucker of metacercaria cyst. Conclusion The morphological figures and parasitic sites of metacercaria, the genital sucker of the adult, and the number and form of the hamulus on the genital sucker provide basis for distinguishing H. pumilio from other intestinal flukes.

ObjectiveTo observe the effect of constraint-induced movement therapy (CIMT) combined with motor imagery therapy (MIT) on the upper extremity function of stroke patients with hemiplegia.Methods120 hemiplegic patients caused by brain injury were randomly divided into the control group, CIMT group, MIT group and combined therapy group with 30 cases in each group. The every group was treated with commensurate rehabilitation management respectively, 4 weeks as one course of treatment. All patients were assessed with the Simple Test for Evaluating Hand Function (STEF), the upper limb movement Fugl-Meyer Assessment (FMA), and Modified Barthel Index (MBI) before and after the treatment.ResultsBefore the treatment, there was no significant difference in STEF, scores of upper limb movement FMA and MBI among the four groups ( P>0.05). After the treatment, the STEF, scores of upper limb movement FMA and MBI of the CIMT group and MIT group improved ( P<0.05), that of the combined therapy group were superior to any other group ( P<0.01).ConclusionCIMT and MIT can promote the recovery of upper extremity function of hemiplegic patient, but the better therapeutic effect will be obtained when these two therapies combined.

In order to understand the situation of schistosomiasis in Fujian Province, the surveillance and field survey data of 16 counties (cities or districts) were statistically analyzed from 2003 to 2008 according to the national and provincial surveillance protocols. The snail areas were 69 400 m~2 in 2003, and 506 700 m~2 in 2004, then decreased to 57 700 m~2 in 2008 after the snail control in 2005 and 2006. Serological examinations were conducted in 18 000 people, among which 5 412 people were the mobile population from schistosome-endemic areas, and 110 persons were positive, among which 8 persons had eggs and miracidia in their stools, among 7 885 appendix samples, Schistosoma japonicum eggs were found in 8 samples of the patients who came from the o-riginal endemic areas. By the stool examination, 2 709 head of farm cattle in the region with snails were not found infected with Schistosoma japonicum. It is suggested that the areas of residual snails are large and widespread, and the imported patients are found frequently, so the danger of schistosomisis transmission still remains.

Objective:Imatinib is extensively used as a first-line therapeutic agent for patients with chronic myeloid leukemia (CML) at the chronic phase (CP). Although CML patients undergoing imatinib treatment are enrolled mainly in the Glivec International Patient Assistance Program (GIPAP) in China since 2003, limited data have been reported on the long-term outcome of these patients. This study aims to compare the treatment response and prognosis of CML-CP patients who received different treatments from January 2003 to December 2013 in the First Affiliated Hospital of Nanchang University. Methods:A total of 295 patients were enrolled, includ-ing 185, 30, 50, and 30 patients for imatinib, interferon-alpha (IFN-α) plus Ara-C, hydroxycarbamide (HU), or allogeneic hematopoietic stem cell transplantation (Allo-HSCT) treatments, respectively. Results:Patients in imatinib and Allo-HSCT groups achieved excellent complete hematologic remission (CHR) (i.e., 96.7%vs. 96.7%), complete cytogenetic response (CCyR) (i.e., 89.7%vs. 93.3%), and com-plete molecular remission (CMoR) (i.e., 49.7%vs. 83.3%, P=0.001). However, significantly low rates of CHR, CCyR, McyR, and CMoR were observed in IFN-αand HU groups. Moreover, patients from imatinib group showed longer overall survival (OS) time than patients from other groups (P<0.001), even patients in Allo-HSCT group (10-year OS, 89.0%vs. 67.0%, P<0.001) because of high risk of Allo-HSCT-related complication. Multivariate analysis showed that receiving imatinib treatment (HR=5.267, 95%CI:1.054-1.940, P=0.022) and achieving CCyR (HR=9.541, 95%CI:1.692-10.513, P=0.002) were independent predictors for OS. Conclusion:Imatinib treatment may be an optimal first-line choice for Chinese patients with CML-CP who have not received any previous treatments.

Objective:This study aimed to achieve the early diagnosis and active treatment of adult hemophagocytic syndrome (HPS) and investigate the clinical characteristics and prognostic factors of this syndrome. Methods:A single-center retrospective analysis was performed to analyze clinical characteristics, laboratory findings, and survival data. Results:In 58 patients, the most common clinical manifestations were fever (100%) and splenomegaly (89.7%). The most common laboratory parameters were serum ferritin 500 g/L (100%) and peripheral cytopenia in two or more lineages (96.6%). platelet count, fibrinogen, and lactate dehydrogenase in the death group were significantly lower than in the survival group (P=0.000, 0.001, and 0.000). Survival analysis results showed that infections in the rheu-matological group exhibited good prognosis [the overall survival (OS) time was not reached in 190 d]. Patients with unexplained causes had moderate prognosis (OS time was 60 d);tumor-associated HPS patients had poor prognosis (the OS time was only 30 d). Univariate analysis results showed that patients with Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2000 U/L also exhibited poor prognosis (P=0.000). Multivariate analysis results showed that PLT<40 × 109/L was an independent adverse factor (HR=6.472, 95%CI:1.526-26.065, P=0.011). Conclusion:HPS exhibits complex clinical manifestations and varied etiology. Patients with infection and rheumatism-related HPS had good prognosiss compared with those manifesting tumor-associated HPS. Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2 000 U/L were the univariate factors that affected the survival time of patients. PLT<40×109/L is an independent adverse factor. These patients need systemic treatments as early as possible.