Objective To explore the correlation factors of hospital stay and hospitalization costs among patients with acute ischemia stroke (AIS). Methods The clinical data of the patients with first diagnosis of AIS at Peking University Third Hospital in China from January 1 , 2012 to December 31 , 2012 were retrospectively analyzed to investigate the correlation factors of hospital stay and hospitalization costs using univariate analysis and multiple regression analysis. Results The study involved 496 patients, with a mean age of 63.38 years (range:26~88 years). Multivariate regression analysis showed the significant impact factors for LOS were age, pneumonia, the total score on NIHSS, medication for secondary prevention and stroke subtype. The significant impact factors for cost of hospital stay were payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention. Conclusions Age, pneumonia, the total score on NIHSS, stroke treatment and its subtypes are the significant impact factors affecting hospital stay. Payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention are the significant impact factors affecting costs of hospitalization.

BACKGROUND:Knee osteoarthritis and rheumatoid arthritis are common arthritis in the knee.In late stage of arthritis,severe deformation and activity obstacle are found,which require total knee replacement.The total knee replacement not only can significantly relieve symptom,but also correct deformation and improve joint function.OBJECTIVE:To summarize classification of knee joint,techniques of knee replacement surgery and complications following replacement.METHODS:We retrieved Vip Database (http://www.cqvip.com) for titles and abstracts with the key words of "knee replacement,prosthesis,complication".Articles concerning clinical application of knee prosthesis were included.Articles in the same field that published recently or in authorized journals were included.A total of 20 literatures were included for review according to inclusion criteria.RESULTS AND CONCLUSION:Various artificial total knee prostheses were used in different patients in accordance with patients' condition,joint limitation degree,fixation method and meniscus function.Indication of different knee prostheses depends on bone and soft tissue of the knee,and quality and status of knee ligament,joint deformation and destruction degree of articular cartilage are responsible for the choice of prosthesis.Thrombosis of deep veins of the lower limb,pulmonary embolism,infection surrounding the prosthesis and prosthesis loose are common complications in joint replacement.

Objective To explore clinical effect of nedaplatin combined gemcitabine on chemotherapy of advanced non-small cell lung cancer (NSCLC),and to observe the prognosis and complications of these patients. Methods 106 patients with advanced NSCLC were selected,they were randomly divided into the treatment group and the control group with 53 cases each group,according to the single and double of order registration number.The con-trol group were given cisplatin combined gemcitabine chemotherapy,the treatment group were administrated nedaplatin combined gemcitabine chemotherapy,three weeks repeat.The treatment effect was estimated after two cycles of chemo-therapy,and progression-free survival ( PFS) ,patients quality of life with KPS after treatment,and the adverse reac-tions were assessed.Results The disease control rates (DCR) of the treatment group was 77.36% (41/53),the control group was 71.70%(38/53),there was no statistically significant difference (χ2 =2.46,P>0.05).PFS of the treatment group were (4.26 ±0.38) months,the control group was (3.72 ±0.30) months,there was no statisti-cally significant difference (t=2.94,P>0.05).KPS of the treatment group was (74.48 ±4.04)points,which was higher than (69.76 ±3.28)points of the control group,the difference was statistically significant (t =7.33,P<0.05).The total adverse reaction of the treatment group was 81.13%(43/53),which was lower than the control group 90.57%(48/53),the difference was statistically significant (χ2 =7.61,P<0.05).Conclusion There is preferably clinical effect of nedaplatin combined gemcitabine treatment of NSCLC,the adverse reactions was lower sig-nificantly,the patients prognosis is good,and which is worth clinical promotion.

Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Humans ; Male ; Musculoskeletal Manipulations ; Osteitis ; pathology ; therapy ; Sacroiliac Joint ; pathology ; Sclerosis ; therapy ; Young Adult

In order to improve the teaching effect ,we tried to use problem-based learning(PBL)in combination with traditional teaching method to teach medical students in clinical probation of Gynecology and Obstetrics. The results showed that PBL in combination with traditional teaching method was possible and effective. PBL was helpful to cultivating the clinical consciousness and comprehensive diathesis of medical students.

Aneurysm, Dissecting ; classification ; surgery ; Aortic Aneurysm ; etiology ; Dilatation, Pathologic ; Humans ; Stents ; adverse effects

Objective To evaluate the relationship between 18F-FDG uptake and P-gp expression in Bcap37 or Bcap37/MDR1 tumor-bearing BALB/c nude mice.Methods Bcap37 or Bcap37/MDR1 cells were injected into BALB/c nude mice (1× 107cells/ml,0.2 ml/mouse) to construct mice models.Bcap37 (n=5) or Bcap37/MDR1 (n=5) tumor-bearing mice fasted for 6 h before imaging.After anesthesia,the mice were injected with 7.4 MBq of 18F-FDG via tail vein.The dynamic microPET scans were carried out for 90 min.On the microPET images,the ROI was drawn and the TAC was obtained.The next day,those 10 mice underwent dynamic microPET scans after injected with elacridar (GF120918) and 18F-FDG.Another 10 mice,5 with Bcap37 tumors and 5 with Bcap37/MDR1 tumors,were used.After 7.4 MBq 18F-FDG with or without 2.0 mg/kg GF120918 was administered via tail vein,microPET images were acquired at 60 min.ROI was drawn over the tumors and SUV was obtained.Two-sample t test was used to analyze the data.Results GF120918 did not significantly alter the 18F-FDG accumulation curve in Bcap37 tumors,but significantly enhanced the 18F-FDG accumulation in Bcap37/MDR1 tumors.GF120918 did not influence 18F-FDG uptake (SUV) in Bcap37 tumors (1.052±0.028,1.028±0.045,t =1.792,P＞0.05),but significantly increased the SUV in Bcap37/MDR1 tumors (1.015±0.043,0.712±0.031,t=3.365,P＜0.05);The SUV of 18 F-FDG in Bcap37 tumors was significantly higher than that in Bcap37/MDR1 tumors without injection of GF120918 (t =3.952,P＜0.05).The SUV was not significantly different when GF120118 was injected (t=1.835,P＞0.05).Conclusions 18F-FDG is a substrate of P-gp.18F-FDG imaging combined with GF120918 injection may be an effective noninvasive method for the detection of tumor's MDR.

Radiation therapy is one of the important comprehensive treatment strategies for thoracic neoplasms,but it also can cause radiation-induced heart disease (RIHD) which can affect the quality of life and even endanger the lives of patients while killing tumor.With the development of comprehensive treatment for cancer,the patients achieve better survival outcomes.And the study reported about RIHD increased as well,which made RIHD became an important complication of thoracic neoplasms' treatment.Though modem radiotherapy techniques and new therapeutic principles have significantly made the incidence of RIHD decreased,the harm of RIHD should not be ignored.In this article,we review the research progress of RIHD.

Objective To study the mechanism of adaptive immunity against Rhizopus arrihizus (R. arrihizus) infections. Methods Bone marrow derived dendritic cells (BMDCs) were separated from C57BL/6 mice and Card9-/- mice and then were cultured in vitro. Resting spores and swollen spores of R. arrihizus were in vitro co-cultured with BMDCs with or without Syk inhibition. Secretion of cytokines ( IL-23, IL-1βand IL-12) was analyzed by ELISA after 24 hours of culture. Na?ve T cells derived from C57BL/6 mice were in vitro co-cultured with spore-stimulated BMDCs for four days. Levels of IL-17A and IFN-γ in supernatants of cell culture were analyzed by ELISA. Flow cytometry was performed to analyze T cell differ-entiation. Confocal microscopy was used to observe the images of stained β-glucan on the surface of resting and swollen spores. Swollen spores were co-cultured with Dectin-1, Dectin-2, TLR2 and mannose receptor ( MMR) , and the binding results were analyzed by flow cytometry. Results Swollen spores but resting spores could induce the maturation of BMDCs and promote the secretion of cytokines (IL-23, IL-1βand IL-12). Co-culturing T cells with swollen spore-stimulated BMDCs enhanced their differentiation to Th17 and Th1. In addition, swollen spores promoted the secretion of Th1-related cytokine ( IFN-γ) and Th17-related cytokine (IL-17A). Adding Syk inhibitor to Card9-/-BMDCs or wild type BMDCs significantly inhibited the secretion of cytokines and T cell differentiation, especially in the Card9-/- group. β-glucan was overserved on the surface of swollen spores, but not on resting spores. On the surface of swollen spores existed pathogen associated molecular patterns ( PAMPs) that could bind with Dectin-1 and TLR2. Conclusion Swollen spores of R. arrihizus could active BMDCs to secrete cytokines of IL-23, IL-1β and IL-12 and trigger T cell responses in vitro. The possible mechanism might be associated with β-glucan exposed on the surface of swollen spores that binds with Dectin-1. The responses between BMDCs and R. arrihizus are Syk-Card9-dependent.

Objective To identify the effect of health risk behaviors on accidental injury of adoles-cents.Then analyze the strength and approach of the health risk behaviors. Methods Cluster sampling on various stages and strata methods was adopted. The adolescents from grade one to three in junior school students and grade one to three in senior high school students completed the questionaire. A total of 4408 students were surveyed and 4309 samples were valid. Path analysis was used to understand how factors could influence injury incidence. Results The incidence of adolescent injury was 15.53%. Statistical differences were found between genders (male 17.77%,female 13.36%,χ2=15.91, P<0.01),education levels (junior high school 17.36%,senior high school 13.99%,χ2=11.45, P<0.01) and cities ( Beijing 12.97%,Zhongs-han 17.95%,χ2=20.33, P<0.01) . Those who got injured were found with more health risk behaviors. Health risk behavior was the direct influencing factor to injury,as well as a possible risk factor to multiple injuries. Conclusion Health risk behaviors can strongly affect adolescent injury,and can be an indicator. Reducing health risk behaviors is important in adolescent injury prevention.