Diabetes-related macular exudation is a common fundus change associated with diabetes mellitus,charactered by hard exudates of macular area.It is one of main causes of lowing vision in diabetic patients.The incidence of diabetes-related macular exudation is increasing recent years,and therefore the diabetic maculopathy is also a matter of urgent concern.Domestic and international studies suggested that many systemic factors,such as blood glucose level,blood pressure,hypertension,higher blood lipid,inflammatory factors and genetic predisposition,exert impacts in the pathogenesis and development of diabetic retinopathy.However,whether the hard exudates of macular area also is associated with systemic factors mentioned above is unclear up to now.Since the hard exudates of diabetic maculopathy may leads to permanent loss of visual function,it is very important for us to find the effective prevent and managing approaches.This paper aimed to review the progress in this field and summarize the relevant risk factors that must be strictly controlled.

Staphylococcus aureus continues to be a major pathogen in both community and healthcare associated infections.The pathogenicity of staphylococcus aureus is a complex process involving a variety of extracellular and cell wall components that are coordinately expressed during different stages of infection.Accessory gene regulator (agr)-mediated quorum sensing plays a major role in staphylococcal pathogenesis.However,agr dysfunction strains exist extensively in staphylococcus aureus clinical isolates.This review will mainly focus on the influence of agr dysfunction on staphylococcus aureus biofilm formation,clinical course and outcome of infectious diseases,and antibiotic resistance.

Sepsis is a complex systemic inflammatory response syndrome caused by infection.Sepsis can deteriorate to severe sepsis,septic shock,and multiple organ dysfunction syndrome.Due to the use of antimicrobial agents,fluid resuscitation and the developments of all kinds of support life,the treatment of sepsis has greatly improved over the past years.However,the mortality rates of sepsis still remain high.Rapid,accurate and early diagnosis of sepsis is a key factor to lower the high mortality rate of sepsis.Recently,it has been found that some biomarkers are closely associated with early diagnosis of sepsis and are helpful for the treatment.These biomarkers for early diagnosis include presepsin(sCD14-subtype),neutrophil CD64,soluble triggering receptor expressed on myeloid cells-1 (sTREM-1),soluble CD163,microRNAs,copeptin,and so on.Examining these biomarkers alone or in combination will bring new opportunities for the early diagnosis of sepsis,and hopefully provide new ideas for the treatment of sepsis.This article reviews the progress on the current emerging biomarkers for early diagnosis of sepsis.

This article introduces the classifications of medical devices by FDA and EU and compares them with the situation in China. Towards the problems found, several reasonable advices are put forward.
China ; Durable Medical Equipment ; classification

Behcet Syndrome ; Child ; Humans ; Intestinal Diseases ; Male

Objective:To analyze the nuclear proliferation in breast cancer tissue related antigen (Ki-67) and proliferating cell nucleus antigen ( PCNA ) expression changes and the relationship between breast cancer and its relationship to breast cancer chemotherapy sensitivity, provide theoretical basis for clinical effective chemotherapy of breast cancer.Methods: Subjects from our hospital in recent years,by clinical examination,84 cases of patients diagnosed with breast cancer,breast cancer tissue were measured with immunohistochemical method of Ki-67 and PCNA content, compared different Ki-67 and PCNA expression levels of patients undergoing chemotherapy curative effect difference.Results:Ki-67 positive cases for 52 cases,PCNA positive cases of 62 cases.Ki-67 positive rate and the patients with lymph node metastasis and tumor classification stage were positively correlated,the difference was sta-tistically significant,P<0.05).The PCNA positive rate and the tumor was closely relative to lymph node metastasis,P<0.05,has nothing to do with tumor clinical classification stage(P>0.05).The total effective rate of Ki-67+was significantly higher than that of Ki-67-(80.8%and 56.2%,P<0.05).Effective rate of PCNA-significantly higher than that of PCNA+(72.7% to 45.2%,P<0.05).Conclusion:Ki-67 clinical data and PCNA expression is closely related to breast cancer and chemotherapy sensitivity.It can be used as a prediction index of curative effect of chemotherapy.

Objective: To explore the relationship between ERCC 1, Ki67, PCNA expression with anthracycline chemotherapeutic drugs′sensitivities in breast cancer tissues.Methods:The ERCC1,Ki67,PCNA expression in 93 breast cancer tissue was detected by immunohistochemical staining.The efficacy of chemotherapy was observed and the difference of anthracycline chemotherapy effect among patients with different ERCC 1,Ki67,PCNA expression was compared.Results:The positive rate of ERCC1 was 65.59%,the positive rate of Ki67 was 69.89%,the positive rate of PCNA was 64.52%.The total effective rate of ERCC 1-positive group was 50.82%,and ERCC1-negative group was 84.38%.In Ki67-positive group,the effective rate of patients in 25%-50%intensity was 73.68%, the effective rate of patients in 50%-75% intensity was 85.71%, the effective rate of patients in >75%intensity was 88.89%, and Ki67-negative group was 60.71%.In PCNA-positive group , the effective rate of patients in 25%-50%intensity was 52.94%, the effective rate of patients in 50%-75% intensity was 62.07%, the effective rate of patients in >75%intensity was 71.43%, and PCNA-negative group was 81.82%.These differences were all statistically significant ( P<0.01 ,P<0.05 , P<0.05).Conclusion: There are correlations between ERCC1,Ki67,PCNA expression with anthracycline chemotherapeutic drugs′sensitivity of patients with breast cancer.Combined detection of multi-factor in clinical is more helpful for the selection of chemotherapy drugs and the formulation of chemotherapy regimen.

Objective To investigate the information ability of medical personnel from a large general hospital that integrates medical care,teaching and research under the network environment for providing evidence to improve targeted information service in library.Method A self-designed and self-administered questionnaire was distributed through the questionnaire system on hospital office network.Information ability involved in the questionnaire mainly included the ability to precisely retrieve literature in Chinese and foreign language,commonly used retrieval strategies,and screening,evaluation and English full-text access methods.A total of 1 094 medical personnel voluntarily participated and completed the questionnaire,and complete responses were obtained from 1 065 individuals (effective response rate 97.35％).x2 and trend x2 tests were used for data analysis.Results The overall accuracy of precise retrieval information was only 6.1％,and the accuracies of precise retrieval literature in Chinese and foreign language databases were 14.6％ and 14.6％,respectively.Duty,education and working years of the medical personnel had significantly effects on the ability to precisely retrieve literature and the strategies and methods of information retrieval,screening,evaluation and full-text access.Conclusion Medical personnel had certain information ability,but library should carry out relevant training program to improve the medical personnel's information quality and ability further.

Hepatic veno-occlusive disease (HVOD) is a serious complication of hematopoietic stem cell transplantation.The mortality rate of severe HVOD (sHVOD) approaches 100 ％.Defibrotide (DF) is a polydisperse mixture of single-stranded oligonucleotides with antithrombotic and fibrinolytic properties.Numerous clinical trials have demonstrated its effectiveness and safety in the prevention and treatment of HVOD.This review focuses on the possible mechanisms of action of DF and its use in the prevention and treatment of HVOD.

Objective To discuss the safety management of hemodialysis equipment for safe and effective treatment to patients.Methods The management methods were summarized in aspects of the installation,utilization and maintenance of hemodialysis equipment.Results The hemodialysis patients received the safe and effective treatment through the strict management and the standardized system.Conclusion The standardized management can not only reduce the unnecessary failures of the equipment,and prolong the service life,but also increase the utilization rate of the equipment,and provide the best,safest and most satisfactory treatment for patients.