Objective To find out about the risk factors and prevention and treatment measures for complication with hospital infection in patients with primary nephrotic syndrome. Methods An analysis was conducted by means of retrogressive survey of the relevant clinical data on 146 cases of patients with primary nephrotic syndrome. Results The rate of hospital infection in patients with primary nephrotic syndrome reached 35 6%, with the respiratory tract being the main infected site(46 4%) and the urinary tract being the next major infected site(17 9%); the rate of infection is related to such factors as length of stay(P

Objective:To investigate procalcitonin and C-reactive protein levels in diarrheal patients who underwent irinotecan che-motherapy. Methods:Procalcitonin and C-reactive protein were detected among 85 diarrheal and 63 non-diarrheal patients after irinote-can chemotherapy. Results:According to WHO classification, patients without diarrhea are classified as grade 0, whereas patients with diarrhea can be classified as gradesⅠ-Ⅳ. In grades 0,Ⅰ,Ⅱ,Ⅲ, andⅣpatients, the levels of procalcitonin were 0.29 ± 0.17, 0.30 ± 0.18, 0.36 ± 0.20, 1.24 ± 0.22, and 2.15 ± 0.26 ng/mL on the second day, respectively. However, on the fourth day, the procalcitonin lev-els were 0.28 ± 0.15, 0.30 ± 0.14, 0.34 ± 0.18, 2.00 ± 0.22, and 2.40 ± 0.28 ng/mL, respectively. Moreover, in grades 0,Ⅰ,Ⅱ,Ⅲ, andⅣ, the levels of C-reactive protein were 6.06 ± 1.85, 6.12 ± 1.16, 6.20 ± 1.68, 22.62 ± 4.55, and 31.26 ± 5.23 mg/L on the second day, respectively. On the fourth day, the C-reactive protein levels were 5.80 ± 1.82, 5.94 ± 1.14, 6.15 ± 1.55, 30.52 ± 4.74, and 38.67 ± 5.68 mg/L, respectively. No significant difference was found between the procalcitonin and C-reactive protein levels of stagesⅠandⅡpa-tients (P>0.05), but a significant difference was found between stagesⅠ, andⅡpatients and stagesⅢandⅣpatients (P<0.05). Con-clusion: Monitoring levels of procalcitonin and C-reactive protein may be helpful in the early evaluation of the severity of diarrhea. This process has prognostic effect and can be used to assess whether patients have enterogenous bacterial infection. Monitoring the lev-els of these proteins has certain clinical value and can be used to guide early anti-infection therapy.

Objective To study on the effectiveness of endoscopy in diagnosing the gallbladder-intestine fistula. Methods The clinical datum of 24 patients with gallbladder-intestine fistula from January 1982 to March 2004 were reviewed and analyzed retrospectively. All patients were examined by endoscopy and confirmed from operation. Results Twenty-one out of 24 patients were finally diagnosed by endoscopy while 3 of them were misdiagnosed. Other examinations among the 24 patients included B ultrasound 11 , computer tomography (CT) 5, and abdominal plain films 7; none of them was finally diagnosed by these measures. Two out of 8 patients were finally diagnosed by barium meal or enema roentgenogram. Conclusion Endoscopy was an important method in diagnosing the gallbladder-intestine fistula. The diagnostic level would be improved if the specific characters of endoscopies in this entity were fully recognized.

Objective To investigate the clinical effect of laparoscopic radical hysterectomy in the treatment of early-stage endometrial cancer.Methods A total of 60 consecutive patients preoperatively diagnosed as having stage Ⅰ or Ⅱ endometrial cancer from August 1998 to December 2004 was divided into two groups,receiving either laparoscopic(Laparoscopic Group) or open radical hysterectomy(Open Group).According to the involvement of the muscular layer,whether or not a pelvic lymphadenectomy was required was determined.Perioperative parameters and survival time were prospectively studied.Results As compared with the Open Group,the Laparoscopic Group presented a longer operation time(247.8?77.8 min vs 196.6?63.7 min;t=2.789,P=0.007),similar blood loss(265.0?187.6 ml vs 350.0?210.9 ml;t=-1.649,P=0.104),similar number of resected lymph nodes(22.0?5.0 vs 22.8?5.2;t=-0.607,P=0.546),insignificant difference in complication rate (10/30 vs 15/30;?2=1.714,P=0.190),earlier time to first passing flatus(44.3?11.1 min vs 55.2?12.8 min;t=-3.524,P=0.000),and shorter hospital stay(8.7?3.2 d vs 10.2?2.0 d;t=-2.177,P=0.034).The patients in the Laparoscopic Group were followed for 28.6?17.4 months with tumor-free survival.In the Open Group,a follow-up for 28.9?16.6 months found 3 deaths form metastasis or recurrence.Conclusions Laparoscopic radical hysterectomy and pelvic lymphadenectomy may be an alternative for early-stage endometrial carcinoma.

Objective To investigate the changes of coagulation function in the neonates patients with gastrointestinal dysfunction and chnical significance. Methods Forty neonates with gastrointestinal dysfunction were included, which were divided into three groups according to diagnosis criterion of gastrointestinal dysfunction: early group, medium group and late group. Coagulation function was tested and neonatal critical illness score(NCIS) was done. Forty normal neonates were selected as control group. The difference of coagulation function among all groups was observed, and the relationship between coagulation function and NCIS were evaluated. Results Compared with control group, the indexs of coagulation function of early group was no statistical difference (P>0.05), however the result between medium group and late group was significantly difference (P<0.05). The difference of coagulation function between medium group and late group was also significant (P<0.05), the lower NCIS was, the more serious the gastrointestinal function was. Conclusions The more serious the gastrointestinal dysfunction is, the poorer the coagulation function is and the lower the NCIS is, which suggest coagulation function should be monitored in neonates with gastrointestinal dysfunction, and early intervention should be done accordingly.

12 weeks of gestation. Results No conversions to open surgery were needed, and no complications were observed. The operation time, intraoperative hemorrhage volume, time to first passing flatus, and length of hospitalization were respectively 109.2?14.4 min, 80.5?14.3 ml, 21.1?3.2 h, and 4.2? 0.4 d for CISH, 108.7?14.8 min, 79.8?10.0 ml, 20.6?2.7 h, and 4.2?0.4 d for LAVH, 107.6?24.2 min, 80.8?17.2 ml, 20.4?2.0 h, and 4.1?0.5 d for LSH, and 110.0?12.3 min, 80.0?18.7 ml, 20.8?1.9 h, and 4.2?0.5 d for LTH. The modified surgical procedures were successfully accomplished in all the 40 patients with extended uterus. Conclusions Different types of laparoscopic hysterectomy present different indications, advantages and disadvantages. The treatment should be individualized.

BACKGROUND: Up to date, studies concerning capspase 3 inhibitor mainly focus on peptide/non-peptide compounds synthesis and detection. Few reports addressing inhibits chondrocytes apoptosis using silenced caspase 3 gene. OBJECTIVE: To inhibit apoptosis of chondrocytes by blocking the apoptotic cascade reaction, gene silencing of caspase 3, and transduction of caspase 3 siRNA into chondrocytes with lentivirus vector.DESIGN, TIME AND SETTING: A single sample observation was performed at the Institute of Traumatic Surgery, Guangzhou Red Cross Hospital, Medical College of Jinan University from June 2008 to June 2009.MATERIALS: Chondrocytes were harvested from SD rats, and caspase 3 shRNA plasimid was constructed by our laboratory.METHODS: Rattus caspase 3 siRNA was synthesized and cloned into pSIH1-H1-copGFP plasmid. pSIH1-H1-copGFP-caspase 3 siRNA lentivirus was generated in 293TN cells by pPACKH1~(TM) Lentivector Packaging Kit and transducted into chondrocytes of rats.MAIN OUTCOME MEASURES: After the lentivirus was transducted into chondrocytes, the caspase 3 mRNA was tested by RT-PCR and the caspase 3 protein was tested by Western blot. Both the transducted cells and untransducted cells were induced apoptosis by tumor necrosis factor α (TNF-α). Cell apoptosis was assessed by flow cytometry, Annevin V/PI.RESULTS: The transduction rate of caspase 3 siRNA was about 90% by lentivirus vector. The expression of caspase 3 mRNA and caspase 3 protein in transducted chondrocytes was lower than the normal chondrocytes (P < 0.01). When the cells induced apoptosis by TNF-α, the apoptosis rate of the negative siRNA- chondrocytes was 7 times higher than that of caspase 3 siRNA-chondrocytes.CONCLUSION: The caspase 3 siRNA could inhibit caspase 3 expression and decrease drug-induced apoptosis of the chondrocytes.

Enhancing medical humanistic quality education is the essence of medicine and it is also a necessity of conforming to the transformation of medical model.The pathological teachers should improve their humanistic quality actively,integrate humanistic quality training into pathology teaching and focus on training the social responsibility and healthy psychological qualities in order to enhance medical students' humanistic accomplishment and to make them become high qualified medical talents.

Objective To explore the relationship between plasma Tumor necrosis factor-alpha(TNF-α),Interleukin-6(IL-6) levels and brain edema caused by hypertensive intracerebral henorrhage.Methods 62 patients with hypertensive intrscerebral hemorrhage( the observation group) and 50 healthy persons( the control group) were selected.The expression of plasma TNF-α and IL-6 were determined by ELISA pre-therapy and 1d,3d,7d,14d after treatment in two groups;The volume of cerebral edema was measured by CT.The relationship between plasma TNF-α,IL-6 levels and brain edema caused by hypertensive intracerebral hemorrhage were analyzed.Results Before treatment,the levels of TNF-α and IL-6 in the observation group were( 15.62 ±9.49)μg/L and (67.47 ±6.31 )ng/L,which were significandy higher than(8.28 ± 3.36) μg/L and(31.02 ± 3.51 ) ng/L of the control group( t =9.17,64.28,P =0.01 ),and Spearman analysis showed that the levels of TNF-α and IL-6 were positively correlated with the volume of cerebral edema(r=0.934,P=0.02;r=0.922,P =0.026).Conclusion There was an up-regulation of TNF-α and IL-6 levels in the plasma of patients with hypertensive intracerebral hemorrhage.TNF-α and IL-6 may promote the formation of cerebral edema during the course of hypertensive intracerebral hemorrhage.

Objective To analyze the characteristic of twenty-item premature behavioral neurological assessment,and to assess the risk factors of neonatal behavioral neurological assessment(NBNA) in premature infants. Methods Total two hundred and seventy-four premature infants hospitalized in Guangzhou Children's Hospital were assessed with the NBNA after correcting age 40 weeks,premature infants were divided into two groups:normal group (n =221 ) and abnormal group (n =53) according to NBNA. The birth history, mother pregnancy situation, the disease during neonatal period and results in hospital were reviewed,and the risk factors of NBNA in premature infants were assessed. Results There were significant differences in gestational age, birth weight, head circumference, body height, Apgar score, resuscitation time, hospitalization time and total gastrointestinal nutrition time between the two groups( P ＜ 0. 05 ). The incidences of superfoetation,hyaline membrane disease, hemorrhagic and hypoxic brain injury, severe infection, hyperbilirubinemia, hypoglycemia and chronic lung disease were different between the two groups( P ＜ 0. 05 ). There were no differences in gender, antenatal hormone use, anaemia, hypotension and evoked potential abnormality (P ＞0. 05 ). Multivariate logistic regression analysis showed that the risk factors of NBNA score in premature infants would include low Apgar score, low birth weight, hyaline membrane disease, hemorrhagic and hypoxic brain injury, severe infection, hyperbilirubinemia, hypoglycemia and chronic lung disease. Conclusion Although the premature infants corrected age 40 weeks,but the capability and initiative muscular tension are still lower than term infant. Low Apgar score, low birth weight, hyaline membrane disease, hemorrhagic and hypoxic brain injury ,severe infection ,hyperbilirubinemia,hypoglycemia and chronic lung disease are important risk factors related to premature behavioral neurological assessment.