Third-generation aromatase inhibitors (AIs) have been considered as standard adjuvant endocrine therapy for hor-mone-responsive breast cancer in postmenopausal women. Aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) are prevalent among patients undergoing AI therapy;these symptoms result in reduced quality of life and poor dependence to AI treatment. The mechanisms mediating AIMSS and the effective management of AIMSS have not been extensively investigated. This article re-views the incidence, clinical characteristics, possible mechanisms, and treatment of AIMSS.

Objective To explore the application of “PBL -Seminar” teaching method in nursing teaching for undergraduates majoring in nursing.Methods 54 nursing undergraduates from July 2012 to April 2013 were set as control group receiving the traditional teaching method, and another 52 nursing undergraduates from July 2013 to April 2014 at internship were set as experimental group, receiving “PBL -Seminar” teaching method, and then the two groups were compared in terms of teaching effects.Results The patient satisfaction was obviously improved, and the qualification rate of the nursing students and the comprehensive evaluation score were significantly higher as com-pared with the control group (p <0.5).Conclusion “PBL -Seminar” teaching method can effectively improve the effect of the nursing internship of nursing undergraduates and the teaching quality for the nursing undergraduates.

OBJECTIVE: To analyze the occupational hazardous factors in hospital pharmacy so as to enhance pharmacist’s awareness of self-protection against such hazards. METHODS: The occupational hazardous factors including physical factors, chemical factors and psychological factors etc were analyzed and the countermeasures were discussed. RESULTS & CONCLUSIONS: Pharmacists should be cautious to the occupational hazards, strengthen traning and education, raise awareness of self-protection to guard against the occupational hazard event.

Objective To characterize the effects of AQP1 expression on kidney damage in rat disseminated intravascular coagulation(DIC) caused by lipopolysaccharide(LPS) dosing. Method Fifty male Wistar rats (clean grade) were randomly assigned into 5 groups of 10 rats. The 10 control rats were dosed with 10 ml of 0.9%NaCl solution by a drip via the vena caudalis within 4 h, and blood and tissues were obtained after treatment completion. In the DIC groups, the rats were dosed with LPS (30 mg/kg body weight in 10 ml of 0.9% NaCl solution) by a drip via the vena caudalis within 4 h, and blood and tissues were obtained at 4, 6, 8 and 10 h. The blood platelet(PLT) count, prothrombin time(PT) , activated partial thromboplastin time(APTT), fibrin(FIB) and D-dimer(D-D) were detected. Hematoxylin and eosin(HE) staining was used to examine the pathologic changes in the lung and kidney tissues of each group (both hematologic parameters and tissue pathologic changes were used to judge the course of DIC). The AQP1 gene expression levels in the kidney tissues from the groups were evaluated by the mRNA levels using RT-PCR. Statistical analyses were performed by the SNK- q method. Results The PLT count, PT, APTT, FIB and D-D examinations revealed remarkable changes in all DIC groups compared with the control group (P < 0.01). The AQP1 mRNA level was significantly decreased in the DIC group at 4 h compared with the control group (P < 0.01) , and further decreased to the minimum level in the DIC group at 6 h. Moreover, cloudy swelling of renal tubular cells was observed at 6 h and cell degeneration and necrosis were observed at 8 h among the DIC groups. Conclusions Downregulation of AQP1 mRNA expression occurred before damage to the renal tubular cells in DIC, indicating that AQP1 expression may be involved in the kidney damage observed in rat DIC.

Objective To evaluate the MRI findings and clinical features of methotrexate-induced acute encephalopathy in children.Methods The clinical data and brain MRI obtained in 13 children with methotrexate-induced acute encephalopathy were retrospectively reviewed.The MRI features were analyzed , including information on the location , the signal intensity and follow-up MRI study was performed.Results Of the 13 patients , 2 patients suffered from seizure.Five patients had dysphasia , of which 4 patients had evidence of hemiparesis , 1 patient had right facial palsy.Five patients had unilateral weakness.And left hemiparesis was observed in 1 patient.DWI revealed well demarcated asymmetrical hyperintensity lesions within the centrum semiovale and/or periventricular white matter in 10 patients, corresponding to areas of hypointensity on ADC maps.One case showed hyperintensity areas in the bilateral supratentorial cortex and subcortical white matter on T 2-weighted images with subtle high-intensity on DWI.In all 10 cases there were resolution of the diffusion abnormality , 8 cases displayed residual FLAIR signal abnormalities involving areas of previously seen diffusion restriction , 5 cases showed decreased range of the lesion , 1 case was progressive, and 2 cases were stable.One case with hyperintensity areas in the supratentorial cortex and subcortical white matter showed small residual hyperintensity on T 2-weighted images and resolution of the diffusion abnormality.Conclusions MTX-induced acute encephalopathy often manifests as stoke-like symptoms.DWI is the imaging modality of choice for the detection of acute MTX neurotoxicity , and asymmetrical restricted diffusion in the deep white matter is the characteristic sign.Cytotoxic edema induced by MTX is transient and reversible .

Objective To explore the clinical application value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in diagnosis and treatment of symptomatic patent ductus arteriosus (sPDA) in preterm infants. Methods A total of 107 preterm infants with gestational age of 28-32 weeks and birth weight less than 1500 g who were admitted to the neonatal intensive care unit from October 2013 to September 2014 were recruited. Plasma NT-proBNP were on 4th and 7th day after birth. The echocardiography examination was performed within 30 minutes after the blood was drawn. According to the echocardiography examination on 4th day after birth, the infants were divided into the patent ductus arteriosus (PDA) group (n?=?39) and the control group (n?=?68). According to whether there were signiifcant hemodynamics changes of ultrasonography and clinical symptoms, the PDA group were classiifed into the sPDA group (n?=?20) and the asymptomatic PDA group (asPDA, n?=?19). Then according to whether ibuprofen was taken, the sPDA group was further divided into treatment group (n?=?13) and non-treatment group (n?=?7). Results On the 4th day after birth, the level of plasma NT-proBNP in the sPDA group was signiifcantly higher than that in asPDA group, and the level of plasma NT-proBNP in asPDA group was signiifcantly higher than that in the control group (P??0.05). In the treatment group, the level of plasma NT-proBNP on the 7th day after birth was signiifcantly lower than that on the 4th day after birth (P??0.05). In PDA group, the level of plasma NT-proBNP on the 4th day after birth was positively correlated with ductus arteriosus (DA) diameter, ratio of the left atrium to aortic root diameter (LA/AO ratio) and transductal diameter-to-left pulmonary artery ratio (TDD/LPA) (r?=?0.498-0.670, respectively). The area under receiver operator characteristic (ROC) curve for prediction of sPDA by the plasma NT proBNP on the 4th day after birth was 0.969 (95%CI:0.938-1.000). When the NT-proBNP was 13964 pg/ml on the 4th day after birth, the sensitivity for diagnosis sPDA was 95%, the speciifcity was 95.4%. Conclusions The level of plasma NT-proBNP is signiifcantly higher in preterm infants with sPDA and is decreased after treatment. Plasma NT-proBNP on the 4th day after birth is a sensitive marker for predicting sPDA. Dynamic monitoring of plasma NT-proBNP has important clinical value in selection of the treatment strategy in preterm infants with PDA.

Biobank is an important resource for biomedical research, which plays a tremendous role in basic research of clinical diagnosis and treatment of human diseases.In China, the biobank for major diseases was built mainly by large general hospitals which have capacity to access and store large amount of human samples.Such model of repository building is relatively independent, and flexible in operation, but it also has several defects, such as insufficient resources, duplication even in the same hospital, dispersion, and lack of effective and standardized management.This article focuses on the strategy of the standardization of the repository building in large general hospitals, aiming to promote the clinical research platform building in hospital and invigorate medical development.

Objective To find an ideal method of DNA isolation from blood and especially from clotted blood and to minimize the volume of blood collected for laboratory and clinical tests.Methods DNAs were isolated from antiagglutinated and agglutinated blood samples from auricular veins of 30 healthy subjects. The DNAs of these samples were obtained by a nonenzymatic, nontoxic procedure optimized by us and determinated by agarose gel electrophoesis and PCR. Results The yields of DNA isolated from clotted blood and antiagglutinated blood were (40.2?8.86)mg DNA/L and (39.1?10.2)mg DNA/L, and purities were 1.87?0.11 and 1.92? 0.12. The DNAs that we isolated from all samples had high molecular weight and by PCR the dimorphism of ALU alleles of the 8th intron of t-PA was easy to be obtained, so they were complete and reliable. Conclusion This method is rapid, easy, efficient and nontoxic for isolation of DNA from clotted and fresh blood and meets requirements for clinical testing and molecular biology study.

Animal models of pulmonary artery hypertension (PAH),aiming to simulate human characteristics of the disease,have contributed extensively to understanding the pathophysiology of PAH and the investigation of experimental treatments.The classical models include monocrotaline models,chronic hypoxia model and so on,more new models were investigated in recent years.These animal models were not able to perfectly mimic human pathological characteristics of PAH because of the defect in different aspects.In this review,both typical and novel methods of PAH modeling were summarized and evaluated to provide a suitable guidance for the settlement of animal models which can meet human characteristics comprehensively.

Objective To investigate the incidence and risk factors of acute kidney injury (AKI). Methods The clinical data of 438 patients with severe pneumonia who were admitted in the intensive care unit in 2016 were retrospectively analyzed for analysis of AKI and assessment of risk factors. Results Among the 438 patients with severe pneumonia,the incidence of AKI was 53.42%. Within 72 hours after admission into the ICU, 86.75% of them developed AKI mainly from hypovolemic or septic shock(accounting for 80.34%). The detection rate of AKI by the standards of RIFLE and AKIN was lower than by the standards of KDIGO (45.89%,48.17%vs. 53.42%). Anemia ,shock /hypotension ,drugs ,RRT ,APPACHE II scores were the predictors of AKI. Conclusions The incidence of severe pneumonia complicated with AKI is high. Most of the patients develop it in 72 hours after admission into the ICU. Anemia,shock/hypotension,drugs,RRT,APPACHE II scores are its risk factors.