Objective To observe the clinical efficacy and security of anti-tuberculosis combined with highdose methylprednisolone in treatment of advanced tuberculous meningitis.Methods 77 patients with advanced tuberculous meningitis in our department were randomly divided into the observation group(39 cases)and the control group (38 cases).All of the patients were given initiate antiphthisie treatment,the control group were added dexamethasone,20mg/d,iv drip,then was maintained after improved;the observation group were added high-dose methyprednisolone(500mg/d)by intravenous injection for five days,then was given methyprednisolone 80mg/d to maintain.Two groups were treated with hormone no more than three months.Then the clinical efficacy and adveme reaction were compared.Results The observation group:32 cases of healing,6 cases of effective,1 case of inefficient,the total effective rate was 97.4%and the control group were 22,8,8,78.9%;the difference of total effective rates in the two groups was statistically significant(x2=7.57,P＜0.05).The time of consciousness restoration and defevesence,the white blood cell count,protein chloride and glucose content of cerebrospinal fluid of the observation group were(2.7±1.3)d,(13±5)d,(112.37±27.57)×106/L,(3.04±0.82)g/L,(32.7±6.4)mmol/L and(1.67±0.65)mmol/L;and the control group were(5.2±2.4)d,(19±6)d,(93.74±20.18)×106/L,(1.92±0.64)g/L,(25.4 ±5.2)mmol/L and(1.04±0.34)mmol/L,the difference was statistically significant(t=5.70,4.77,3.88,6.67,5.48,5.31,P＜0.01);The difference of adverse reaction rate between the two groups was not statistically significant (P＜0.05).Conclusion The clinical efficacy of anti-tuberculosis combined with high-dose methylprednisolone in treatment of advanced tuberculous meningitis was better and had advantages in improving symptoms and signs without enhancing the rate of adverse reaction and it was worth to promote in clinical.

Objective To describe the status of resilience and self-care behaviors in chronic heart failure patients and to explore the relationship between resilience and self-care behaviors. Methods It was a cross-sectional survey. The Connor-Davidson Resilience Scale, the self-care behaviors with heart failure questionnaire and the demographic scale were delivered to 150 chronic heart failure patients in Shanghai Changhai Hospital. Results The score of self-care behaviors was (2.63 ± 2.01) points for chronic heart failure patients. The resilience score was (57.56 ± 8.51) points. The resilience was significantly related to the self-care behaviors(r=0.427, P<0.01), and which explained 32.4%of the total variation. Conclusions The chronic heart failure patients have poor self-care behaviors and resilience. More attention should be paid and more action be taken to improve the resilience, then improve the self-care behaviors of patients.

Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; standards ; In Situ Hybridization ; standards ; Neoplasm Invasiveness ; Receptor, Epidermal Growth Factor ; analysis ; metabolism

AIM: To estimate the efficacy of milrnone in treatment of congestive heart failure. METHODS: 122 cases of chronic congestive heart failure with different etiology were divided into milrinone group and dabutamine group randomly. Milrinone group accepted milrinone (10 mg?d -1 ) for 5 days, and dabutamine group accepted dabutamine (160 mg?d -1 ) for 5 days. The efficacy of treatments was evaluated. RESULTS: The effectiveness rates of cardiac function improvement were 93.9 % and 76.7 % in milrinone group and dabutamine group, respectively (P

OBJECTIVE: To analyze the situation and the related problems of Chinese patent drugs including toxicity components used in pediatrics, and to provide the suggestion for the development of Chinese patent drugs for pediatrics. METHODS: 264 Chinese patent drugs which were used in pediatrics were collected from national drug standards, and compared with toxicity drug list. The utilization of toxicity drugs were analyzed statistically. RESULTS: About half of Chinese patent drugs for pediatric included toxicity components. Major problems are complex resource of toxicity components, overdose of toxicity components, single disease and pattern, unscientific determination of amount, etc. CONCLUSION: The in-depth study of Chinese patent drugs requires perfecting national drug standards, to developing more rigorous special approval requirements, to establishing the re-evaluation system and to eliminating unsuitable category of Chinese patent drugs.

Triple-negative breast cancer (TNBC) is a subtype of breast cancer known for the poor prognosis due to its strong invasiveness, high recurrence rate, and lack of effective treatment. Therefore, there is an urgent need to find targeted therapy for TNBC. Cathepsin A (CTSA) is an acidic serine carboxypeptidase that is highly expressed in various tumor tissues. However, the role and molecular mechanism of CTSA in TNBC are still unclear. This study found that the expression of CTSA was upregulated, and the high expression of CTSA was positively correlated with the poor prognosis of TNBC. The results further showed that knocking down CTSA inhibited the proliferation, invasion, and colony formation of TNBC cells, improved drug sensitivity of cells, and inhibited the progression of TNBC. Mechanistically, CTSA inhibited the ubiquitination and degradation of the promyelocytic leukemia protein (PML) protein by blocking the interaction between PML and its E3 ubiquitin ligase RNF4, thus maintaining the stability of PML nuclear bodies (PML-NBs). The inhibitor of CTSA had a positive therapeutic effect on inhibiting the characteristics of TNBC stem cells. In conclusion, this study demonstrates that inhibiting CTSA to decrease the stability of PML protein may be a promising therapeutic strategy for TNBC. All animal experiments in this experiment were approved by the Ethics Committee of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College (approval number: IMB-20240326D502).

Objective To investigate the changes of cesarean section rate and indications in different level hospitals of different areas in China during 2000 to 2009. Methods Literatures published in Chinese journals on variation of cesarean section rate and indications from 2000 to 2009 were analyzed. Cochran-Armitage test was used to analyze the trend. The differences of cesarean section rate between different areas or different level hospitals were analyzed by chi-square test.Results Forty-nine papers were enrolled in this study.Cesarean section rate had risen from 2000 (32.1％,10 353/32 258) to 2009 (52.5％,3674/6992)(Z=-20.8267,P＜0.01).During 2000 to 2008,the average cesarean section rate of level one grade A hospital was 45.7％ (3754/8214),which was higher than 34.5％(25 015/72 507) in level three grade A hospital and 32.3％(28 140/87 121) in level two grade B hospital (P＜0.05,respectively).Except for level three grade A hospital,cesarean section rate had risen in the other two level hospitals during 2003 to 2008. The average cesarean section rate was 58.6％ (4982/8502) in northeast area during 2000 to 2007,which was higher than that of other areas (P＜0.01); and the average cesarean section rate was 27.5％ (12 264/44 595) in central China and 33.0％ (23 239/70 421) in southern China,which were lower than that of other areas (P＜ 0.01 ). Social factor,instead of dystocia,became the most important indication for cesarean section,and its proportion kept rising annually,from 11.3％ (1170/10 353) in 2000 to 27.1％(2094/7726) in 2008 and remained above 20.0％(5159/24 691) since 2004.The proportion of scar uterus rose from 6.7％(694/10 353) in 2000 to 12.5％ (459/3674) in 2009. Conclusions Cesarean section rate rises fast and its major indications had changed in China. It is suggested that special method should be taken to control the current situation.

BACKGROUND:Docetaxel, a cel cycle specific anti-tumor drug, is a drug that is used primarily for treating breast cancer; however, its efficacy is low when used for treatment of cancer not sensitive to radiotherapy. Bone marrow mesenchymal stemcels have been shown to strengthen the effects of tumor-specific targeting chemotherapy drugs. OBJECTIVE:To investigate the effects of docetaxel combined with bone marrow mesenchymal stem cels (BMSCs) on human hepatoma cel line SMMC-7721. METHODS:BMSC cels were culturedin vitro. The logarithmic growth of SMMC-7721 hepatoma cels were randomly divided into blank control group, BMSCs group and combined treatment group (combined treatment of BMSCs and docetaxel). SMMC-7721 cel cycle was detected usingflow cytometry. Cel growth rate of SMMC-7721 was determined by MTT assay. mRNA and protein expressions of tumor suppressor genes PTEN and p53 were detected by reverse transcription polymerase chain reaction and western blot assay. RESULTS AND CONCLUSION:Combined treatment of docetaxel and BMSCs inhibited SMMC-7721 cell proliferation. Compared with the blank control group, the number of cells at the G0/G1 phase was significantly increased in BMSCs group and combined treatment group. The cell growth rate of SMMC-7721 was significantly inhibited in BMSCs group compared with the blank control group, and that was further inhibited in combined treatment group (P< 0.05). mRNA and protein expressionof PTENandp53 were significantly increased in combined treatment group compared with BMSCs group and blank control group (P< 0.05). Our results suggest that BMSCs inhibit the growth of SMMC-7721 cells,andcombined use of docetaxel and BMSCs strengthensthe antitumor effect of BMSCs.

Objective:To explore the influencing factors of physicians' professionalism,to understand the cognitive status and changes of professional responsibility and put forward the corresponding strategy.Methods:The satisfaction and cognitive status of physicians'professionalism were investigated using the self-designed questionnaire that adapted to medical staff,and the data was analyzed using statistical software SPSS19.0.Results:It showed that the satisfaction with the job itself was quite high.But they thought that the work risk was high,their own value was difficult to realized,and the professionalism was lack of cultivation.Conclusions:It suggests to put forward measures and suggestions from the perspective of system reform,vocational education,hospital culture,social atmosphere,decision-making of doctors and patients together.

The paper describes the connotation of a hospitals leaping development, presents the significance of such development, and puts forward several relationships that must be properly handled in order for a hospital to achieve leaping development. These include: ①the relationship between priorities and generalities; ②the relationship between objective possibility and subjective initiative; ③the relationship between ardor and soberness; ④the relationship between innovation and convention; ⑤the relationship between speed and quality; ⑥the relationship between the future and the present; ⑦the relationship between academic leaders and the building of the academic echelon; ⑧the relationship between the construction of the management contingent and the construction of the technical contingent; ⑨the relationship between scale and actual strength; ⑩the relationship between hardware and software; B11the relationship between change and stability; and B12the relationship between leaders and the masses.