OBJECTIVE To investigate the epidemiology of bacterial infections isolated from liver disease patients with septic shock and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy. METHODS A retrospective survey was conducted in 83 liver disease patients with septic shock of our hospital from Jan 2005 to Aug 2006. Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System. RESULTS The infection was frequently identified in intra-abdominal cavity (73.5%),blood stream (24.1%) or respiratory tract (13.3%). The top 3 pathogens were Escherichia coli (36.6%),Klebsiella pneumoniae (15.9%) and Staphylococcus aureus (6.1%). Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to imipenem,levofloxacin or piperacillin-tazobactam. Extended-spectrum ?-lactamases (ESBLs) positive rates of E. coli and K. pneumoniae were 53.3% and 7.7%. Asprergillus and Candida glabrata were the predominant pathogens from fungal infections,and they were mostly resistant to fluconazole. CONCLUSIONS Pathogens of liver disease patients with septic shock are mostly multi-drug resistant. The microbiological surveillance is important for guiding clinical therapy.

Objective To analyze the risk factors of hypoxemia after coronary artery bypasses grafting (CABG) along with cardiopulmonary bypasses and to understand the regular pattern and characteristics of hypoxemia after CABG. Methods The risk factors of hypoxemia were studied by one way analysis and multivariate logistic regression analysis in 86 patients with hypoxemia after CABG along with cardiopulmonary bypass. Results One way analysis indicated that hypoxemia after CABG along with cardiopulmonary bypass was related to senility ( ≥ 65 years ), smoking history, diabetes mellitus, chronic obstructive pulmonary disease ( COPD), left ventricular ejection fraction ( LVEF ＜ 45 % ), obesity before operation, transfusion ( ≥ 1000 ml );multivariate analysis indicated that pulmonary dysfunction before operation, longer extracorporeal circulation time ( ≥2 h), hypoalbuminemia and pulmonary infection were independent risk factors of hypoxemia after CABG along with cardiopulmonary bypass. Conclusion Multiple risk factors contributed to hypoxemia after CABG along with cardiopulmonary bypass. Increase the awareness of risk factors of perioperative hypoxemia may guide the prevention and treatment, even alleviate or avoid the hypoxemia postoperatively.

Objective To assess the prognostic significance of pre-treatment hypercoagulable state in cervical cancer patients. Methods With retrospective analysis, pre-treatment coagulation indicators and platelets from 321 cervical cancer patients from stages I to IV were collected. The pre-treatment coagulation parameters were investigated along with tumor stage and survival data. Result Advanced tumor stage was associated with elevated fibrinogen (Fbg) and platelet (PLT) levels (P < 0.05). Patients with higher levels of Fgb, PTA and PLT suffered from higher risk of recurrence (P<0.05). Multivariate survival analyses showed that tumor stage, Fgb and PTA were independent prognostic factors for disease free survival. Conclusion Coagulation parameters can be served as useful tool for predicting recurrence of cervical cancer.

Objective To investigate the survival of advanced stage periampullary carcinoma and its prognostic factors.Methods The clinical data and follow up of 134 patients with advanced stage periampullary carcinoma admitted to our hospital between January 2007 and December 2010 were retrospectively collected and analyzed.Results Of 134 patients,there were 83 males and 51 females.The mean age±S.D.was 62.49±11.41 (28-83).For the 86 patients who underwent surgery,32 had extensive peritoneal metastases on surgical exploration,27 had metastases/involvement of the liver or stomach,and 27 had major vessel infiltration.For these 86 patients,55 received surgical exploration,whereas 31 had surgical exploration plus bypass anastomosis. 45 patients received chemotherapy,while 67 received chemotherapy plus radiotherapy.The improvements in quality of life and in clinical response rate after concurrent chemoradiotherapy or chemotherapy alone were 73.1％ and 57.8％,respectively.The overall survival was 14.27±1.06 months.The median survival time was 11 (8.95±13.05) months.The 1- and 3-year survival rates were 43％ and 10％,respectively.Karnofsky performance status,and the presence or absence of jaundice co-related with poor prognosis on single factor analysis.The Karnofsky performance status was an independent survival predictor on multifactor analysis.Conclusions The prognosis of patients with advanced stage periampullary carcinoma was poor.Chemotherapy with or without radiotherapy had similar impact on overall survival,Karnofsky performance status was an independent survival predictor.

Objective To study the value of SCCAg,CYFRA21-1 and TPS in the diagnosis and prognostic evaluation of patients with cell cervical cancer (SCC).Methods The levels of serum SCCAg,CYFRA21-1and TPS from 160 SCC patients and 60 health women were detected by means of ELISA.Results ( 1 ) The levels of serum SCCAg,CYFRA21-1and TPS in SCC were significantly higher than those of normal group ( P ＜0.001 ).The median values of normal group:0.43 μg/L,0.43 μg/L,26 U/L,the median values of cervical cancer group:1.96 μg/L,2.29 μg/L,149.1 U/L ( 2 ) The specificity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC were both 100％.The sensitivity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC was 53.42％,40.68％ and 83.95％,respectively.The sensitivity of TPS was obviously different from SCCAg and CYFRA21-1 ( P ＜0.001 ).The sensitivity of SCCAg plus CYFRA21-1 and three markers together were 69.23％and 92.31％,respectively.(3)The expressing of SCCAg,CYFRA21 -1 and TPS in FIGO stages Ⅲ plus Ⅳ was significantly higher than in stages Ⅰ plus Ⅱ (P ＜ 0.05 ),and all markers were not related to the degree of histological differentiation.SCCAg was correlated strongly with tumor size,growth type,lymph node metastasis and age( P ＜ 0.05 ),but CYFRA21-1 was not correlated with all these factors.TPS level was significantly associated with tumor size and lymph node metastasis( P ＜0.05 ),but not with growth type and age.(4)A total of 78 patients were followed up.The pretreatmental serum levels of SCCAg and CYFRA21-1 in patients with recurrence were significantly higher than those without recurrence( P ＜0.05 ).The same trend was not found for TPS.Compared with the normal control,the patients with elevated SCCAg before treatment has shorter intervals before recurrence and metastasis occurred.Also,the survival of patients with elevated SCCAg before treatment was shorter than the normal control ( P ＜ 0.05 ).Conclusion SCCAg,CYFRA21-1 and TPS serum levels are valuable markers for the diagnosis of SCC.Meanwhile,SCCAg and CYFRA21-1 are chnically significant pridictors for the prognosis of SCC.

OBJECTIVETo investigate the mechanism underlying the inhibitory effect of STOML-2 overexpression on apoptosis of human cervical squamous carcinoma Siha cells.

METHODSSiha cells were transfected with an adenoviral vector carrying STOML-2, and 72 h later STOML-2 expression and the proliferation of the cells were detected by Western blotting and MTT assay. The transfected cells were treated with IC50 Cisplatin for 24 h, and the morphological changes of cells were observed using fluorescence, and the cell apoptosis was analyzed using flow cytomerty; the expression levels of proteins related with mitochondrial apoptosis pathway, including caspase-3, cleaved caspase-3, Bcl-2, Bax and cytochrome C (Cyt C), were detected by Western blotting.

RESULTSWestern blotting showed a significantly increased STOML-2 expression in the transfected cells. Overexpression of STOML-2 obviously promoted the proliferation of Siha cells. The STOML-2-overexpressing cells exhibited an obvious resistance to IC50 Cisplatin-induced apoptosis as shown by both fluorescence microscopy and flow cytometry and presented with decreased expressions of cleaved caspase-3, Bax, and cytosol Cyt C and increased expressions of caspase-3, Bcl-2, and mitochondrial Cyt C.

CONCLUSIONSOverexpression of STOML-2 can enhance the proliferation of Siha cells by inhibiting cell apoptosis possibly through the mitochondrial apoptosis pathway.

Apoptosis ; Apoptosis Regulatory Proteins ; Blood Proteins ; genetics ; Carcinoma, Squamous Cell ; metabolism ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Cytochromes c ; metabolism ; Female ; Flow Cytometry ; Humans ; Membrane Proteins ; genetics ; Mitochondria ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; bcl-2-Associated X Protein ; metabolism

Objective To investigate the mechanism underlying the inhibitory effect of STOML-2 overexpression on apoptosis of human cervical squamous carcinoma Siha cells. Methods Siha cells were transfected with an adenoviral vector carrying STOML-2, and 72 h later STOML-2 expression and the proliferation of the cells were detected by Western blotting and MTT assay. The transfected cells were treated with IC50 Cisplatin for 24 h, and the morphological changes of cells were observed using fluorescence, and the cell apoptosis was analyzed using flow cytomerty; the expression levels of proteins related with mitochondrial apoptosis pathway, including caspase-3, cleaved caspase-3, Bcl-2, Bax and cytochrome C (Cyt C), were detected by Western blotting. Results Western blotting showed a significantly increased STOML-2 expression in the transfected cells. Overexpression of STOML-2 obviously promoted the proliferation of Siha cells. The STOML-2-overexpressing cells exhibited an obvious resistance to IC50 Cisplatin-induced apoptosis as shown by both fluorescence microscopy and flow cytometry and presented with decreased expressions of cleaved caspase-3, Bax, and cytosol Cyt C and increased expressions of caspase-3, Bcl-2, and mitochondrial Cyt C. Conclusion Overexpression of STOML-2 can enhance the proliferation of Siha cells by inhibiting cell apoptosis possibly through the mitochondrial apoptosis pathway.

Objective To investigate the mechanism underlying the inhibitory effect of STOML-2 overexpression on apoptosis of human cervical squamous carcinoma Siha cells. Methods Siha cells were transfected with an adenoviral vector carrying STOML-2, and 72 h later STOML-2 expression and the proliferation of the cells were detected by Western blotting and MTT assay. The transfected cells were treated with IC50 Cisplatin for 24 h, and the morphological changes of cells were observed using fluorescence, and the cell apoptosis was analyzed using flow cytomerty; the expression levels of proteins related with mitochondrial apoptosis pathway, including caspase-3, cleaved caspase-3, Bcl-2, Bax and cytochrome C (Cyt C), were detected by Western blotting. Results Western blotting showed a significantly increased STOML-2 expression in the transfected cells. Overexpression of STOML-2 obviously promoted the proliferation of Siha cells. The STOML-2-overexpressing cells exhibited an obvious resistance to IC50 Cisplatin-induced apoptosis as shown by both fluorescence microscopy and flow cytometry and presented with decreased expressions of cleaved caspase-3, Bax, and cytosol Cyt C and increased expressions of caspase-3, Bcl-2, and mitochondrial Cyt C. Conclusion Overexpression of STOML-2 can enhance the proliferation of Siha cells by inhibiting cell apoptosis possibly through the mitochondrial apoptosis pathway.

Medical talent is the core competitive strength for the development of hospitals.Effective recruitment helps hospitals select talents that meet the demands of high-quality development.This article takes public hospitals in Guangzhou as an example and employs literature review and interviews to construct a competency model for public hospital physicians.This model encompasses six dimensions and 20 elements,including clinical skills,knowledge proficiency,professional spirit and qualities,teamwork ability,doctor-patient communication skills,and lifelong learning ability.The established model is applied to various recruitment modules,such as defining recruitment needs,expanding recruitment channels,selecting candidates,standardizing recruitment processes,and improving recruitment evaluation systems,thereby proposing corresponding recruitment strategies for public hospital physicians.

Objective To study the intervention effect of systematic nutrition combined with rhythmic exercise on patients with abnormal liver metabolism. Methods According to the theory of system nutrition and health rhythm kinematics, selected 56 subjects with abnormal liver metabolism were selected, and the combined intervention of system nutrition and rhythm movement was conducted regularly every day for 3 consecutive months using the techniques such as liver transient elastography (FibroScan) and bioelectric whole body health scanning system (DDFAO). Results Compared with the pre-intervention period, the liver fat attenuation, liver hardness and liver functional activity of the subjects were significantly improved after intervention. Conclusion The systematic nutrition combined with rhythmic exercise significantly reduced the risk of abnormal liver metabolism in subjects, which may play an important role in preventing liver diseases and promoting the recovery of liver function.