0.05).EGF expression in the gastric juice and EGFR expression level in the gastric mucosa were increased in the two treatment groups after treatment(P

OBJECTIVE To promote the multidrug-resistant bacteria infection control. METHODS Questionnaire investigated has been used to understand what degree the healthcare workers have known about controlling multidrug-resistant bacteria infection,what difficulties they would be met when they had put prevention and control measures in practice. RESULTS Total 13 questions of prevention and control multidrug-resistant bacteria nosocomial infection,the rate of right answer was 26.9% and the rate of partial right answer was 38.4%.The healthcare workers had lacked of professional knowledge about the prevention and control of multidrug-resistant bacteria nosocomial infection. The major difficulties were crowded wards,short of beds,incomprehension of patients and their families,cost of articles for disinfection and isolation when the medical staff put isolation measures into practice. CONCLUSIONS All prevention and control measures againt multidrug-resistant bacteria infection should be put into practice. We should strengthen training of healthcare workers about professional knowledge,gain support of leaders,and enhance communication between medical staff with patients and supervision.

Objective To study the expression of suppressor gene PTEN in gastric cancer tissues and its relationship with tumor biologic characteristics. Methods Using EnVision immunohistochemical methods, we examined the suppressor gene PTEN expression in 116 cases of gastric cancer, 35 cases dysplasia and 56 cases normal gastric mucosa specimens. Results The positive rate of PTEN (53.4 %, 62/116) was lower in gastric cancer tissue than in dysplasia (71.4 %, 25/35) and normal gastric mucosa specimens(100 %, 56/56) (P

The clinical data of a case of Weave syndrome admitted in the Department of Endocrinology, Children′s Hospital of Nanjing Medical University in October 2018 were retrospectively analyzed.The patient was a 9 years and 2 months old girl, who was hospitalized because of " growing too fast for 9 years" . After birth, the child is found to grow fast and have mental retardation, slurred speech, a blurred vision, a long face, a protruding forehead, ocular hypertelorism, epicanthus, nasal bridge pit, finger pads on both hands and feet, uncoordinated gaits, and intoeingpigeon toes.A novel heterozygous c. 1720A>G (p.K574E) mutation was detected in the exon 15 of the EZH2 gene of the patient.This mutation has not been reported at home and overseas.Sanger sequencing revealed that the patient′s parents did not carry the mutation.The disease is an autosomal dominant genetic disorder, and the parents and sibling of the patient have no corresponding symptoms, so it is inferred that the mutation is spontaneous.Based on the peculiarity of the face, clinical manifestations and the results of molecular genetics, the child was diagnosed as Weaver syndrome.

Objective To evaluate the clinicopathological characteristics and immunophenotype of solitary fibrous tumor (SFT),which is able to provide the basis for clinical diagnosis and prognosis,differential diagnosis and predictable prognosis.Methods Data from 11 cases of SFT were investigated by immunohistochemical.Results Histologically,SFT was composed of spindle cells,which arranged in fascicles pattern,as well as the collagen and branch vessels.Malignant SFT had higher and crowed cellularity with significant pleomorphism,numerous mitoses and putrescence.Positivity for bcl-2 and CD34 was observed in all SFT.Eight tissues showed CD99 positivity,one showed s-100 positivity,all 1 1 tissues showed Ckpan negativity.Conclusions SFT has originated from different sites,which should be distinguished with fibrosarcoma and other spindle cell neoplasms.More attentions should be paid to malignant SFT and focus on the follow-up visit.

Objective To observe the effect of Herba Hedyotis Diffusae(HHD) on expression of heat shock protein 70(HSP70) and P16 anti-oncogene protein in mice with H22 cell transplanted tumor. Methods The mice were immunized with hepatoma-lines-H22 cells which were treated by Chinese herbs firstly. According to the pretreatment of the Chinese herbs and whether the H22 cells being blocked by HSP70 monoclonal antibody,the mice were divided into 5 groups:HHD non-blocking group,HHD-blocking group,Radix Codonopsis(RC)-blocking group,RC non-blocking group,and RPMI-1640 control group. Then the treated H22 Cells were translated into the mice. The expression of HSP70 and P16 anti-oncogene protein in mice with transplanted H22 liver carcinoma was detected by immunohistochemical marking method. Results The expressions of HSP70 was up-regulated in HDD non-blocking group and RC non-blocking group,in particular in RC non-blocking group,and the difference was significant as compared with HHD-blocking group,RC-blocking group and control blank group.The expression of P16 anti-oncogene protein was up-regulated in the treatment groups,and the difference was significant in comparison with the control group. The effect on P16 anti-oncogene protein expression was stronger in HDD groups than that in RC groups,but the difference was insignificant between the blocking group and the non-blocking group of each herb. Conclusion The anti-tumor effect of HDD may be achieved by inducing HSP70 expression in transplanted H22 neoplasia and by enhancing the immunogenicity. The up-regulation of P16 anti-oncogene expression by HHD and RC has no direct relationship with the induction of HSP70,and the related mechanism needs further research.

Objective To explore the effect of ventilator circuit change frequency on the incidence of ventilator-associated pneumonia (VAP). Methods Patients receiving mechanical ventilation in the ICU,Department of Emergency, Respiratory Department and Department of Neurosurgery from March 2008 to September 2010 were randomized into two groups. For these two groups ,the ventilator circuit was changed once or twice a week. The recorded parameters included the clinical symptoms and signs of the ventilated patients. Samples at different parts of the circuit were collected for microbiological detection. The data were analyzed statistically. Results The incidence of VAP was 28. 30% ( 13/53 ) in twice-a-week group and 35.84%( 19/53 ) in once-a-week group. There was no significant difference between the two groups. The rates for positive microbiological detection in the circuit were 48. 16% and 44. 49% for once-a-week and twice-a-week group,respectively. No significant difference was observed ( P ＞ 0.05 ). Moreover, there was no significant difference in terms of the microbiology positivity between different parts of the circuit(P ＞ 0. 05 ). Gram-negative bacteria were the main pathogen of VAP with Acinetobacter baumannii ranking at the top. Conclusion Frequency of Ventilator circuit change does not influence the incidence of VAP. We suggest that the frequency for ventilator circuit change should be once a week. At the same time, the nurse staff should be trained for specific technology and the incidence of hospital infection should be controlled at multiple rings of the chain.

Objective To compare the ear baric function between 4000m altitude chamber test with inhaling air and 6900m altitude chamber test with inhaling pure oxygen.Methods Eleven healthy male volunteers attended two tests as two groups by self-comparison. As the air group the volunteers inhaled air at 4000m, while as the pure oxygen group they inhaled pure oxygen at 6900m altitude, and the time interval between the two tests was more than two weeks. During the test, the volunteers breathed air or pure oxygen at random for 1h, and then were exposed at a speed of 20m/s to the target altitude for 5min. Hereafter they were sent back to the ground at the same speed. The changes of subjective symptoms, degree of tympanic congestion, acoustic immitance index and pure-tone auditory threshold were recorded before and after the test. The acoustic impedance index and pure-tone threshold were statistically analyzed.ResultsFour volunteers (4 ears) in air group and 7 volunteers (7 ears) in pure oxygen group reported ear pain in altitude chamber exposures, respectively. The pain-triggering altitude was higher in the pure oxygen group. Immediately after tests, there were 3 (3 ears) and 5 volunteers (5 ears) with Ⅲ degree congestion of the tympanic membrane in the two groups respectively. Four volunteers (6 ears) developed gradually aggravated hemorrhages after altitude exposure. And the tympanic membrane congestion difference between groups was statistically significant at 3 and 24h after tests (P<0.01). The type A tympanogram appeared in 11 (15 ears) and 11 (14 ears) volunteers respectively immediately after tests. The increase of static compliance value was significantly greater in pure oxygen group than in air group immediately after tests (P<0.05), the decrease of middle ear pressure was more significant in pure oxygen group than in air group at 3 and 24h after tests (P<0.05). Both the two altitude exposure tests resulted in eustachian tube dysfunction. At 3 and 24h after the tests, the increase of individual frequency pure-tone threshold was significantly higher in pure oxygen group than in air group (P<0.05).Conclusion Breathing pure oxygen and lifting height could increase the screening degree of ear baric function test in hypobaric chamber, and have greater influence on degree of tympanic congestion, acoustic immittance and pure-tone auditory threshold in 24 hours.

OBJECTIVETo investigate clinicopathologic features, pathologic diagnosis, differential diagnosis and biological behavior of epitheioid myxofibrosarcoma (EMFS).

METHODSThe clinical and pathological data of 10 cases were collected, and microscopic examination and immunostains were performed along with a review of the literatures.

RESULTSThere were 5 males and 5 females with age ranging from 53 to 74 years, and the mean and median age was 63.6 and 62.5 years, respectively. Six cases developed in the extremities, including upper limbs (n=3) and lower limbs (n=3). Three developed in the trunk and 1 case in the mesentery of sigmoid colon. Tumor size ranged from 4.2 to 7.0 cm (mean, 5.3 cm). Most patients presented with painless masses with duration of 1 to 24 months (mean, 8 months). All 10 patients were treated by surgery, with adjunctive chemotherapy and/or radiotherapy in 4 patients and interventional therapy in 1 patient. Histologically, 8 cases were high grade and 2 were intermediate grade. Like the conventional myxofibrosarcomas, all primary tumors presented a multinodular growth pattern consisting of hypocellular myxoid and hypercellular areas. Prominent curvilinear vessels and pseudolipoblasts were observed in the hypocellular myxoid areas. Besides the spindled neoplastic cells, all tumors were characterized by a variable proportion of epithelioid cells with vesicular nuclei, prominent nucleoli and moderate to abundant eosinophilic cytoplasm. They were arranged singly or in small clusters in the myxoid areas, and in compact sheets in the solid areas. The epithelioid component comprised 30% to 90% of the tumors. In addition, areas with resemblance to undifferentiated pleomorphic sarcoma were also noted, especially in the recurrent tumors. Immunohistochemically, tumor cells showed diffuse staining of vimentin in 6 tested cases with focal expression of smooth muscle actin and epithelial membrane antigen in 1 case each. Ki-67 index ranged from 30% to 80% (mean, 58%). Follow-up data (range, 2 to 74 months; mean, 23 months) were available in 10 cases: 4 patients were alive with unresectable or recurrent disease and 6 patients were alive with no evidence of disease. Five patients experienced local recurrence and 2 cases developed metastasis. The median interval to recurrence/metastasis was 7 months (mean, 9 months).

CONCLUSIONSThe presence of epithelioid cells in a myxofibrosarcomatous background portends an aggressive clinical behavior.EMFS should be differentiated from other myxoid sarcomas with epithelioid morphology.

Actins ; metabolism ; Aged ; Biomarkers, Tumor ; metabolism ; Diagnosis, Differential ; Epithelioid Cells ; pathology ; Female ; Fibrosarcoma ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local

Objective To investigate the significance of whole mount sections after radical prostatectomy in the diagnosis of prostate cancer.Methods The data of 210 patients with radical prostatectomy in the Department of Urology of Northern Jiangsu People's Hospital from April 2018 to July 2015 were collected,of which 150 cases (control group) were examined with routine tissue section examination and 60 cases (study group) were examined with whole mount sections.The age of the study group and the control group were (69.0 ± 5.0) years and (70.0 ± 7.0) years respectively,and PSA was (18.8 ± 2.5) ng/ml and (19.3 ± 2.1) ng/ml respectively.The BMI of the study group was (23.0 ± 1.2) kg/m2,and the control group was (22.8 ± 0.6) kg/m2.The preoperative Gleason score of the study group and the control group were 7.9 ±0.9 and 7.7 ± 1.6 respectively.There were 137 patients (91.3％) with clinical stage cT1-T2 and 13 patients with cT3(8.7％) in control group.In the study group,there were 51 cases (85.0％) with clinical stage cT1-T2,and 9 cases with cT3 (15.0％).There was no significant difference between the two groups (P ＞ 0.05) in term of the patients' demographics.The postoperative Gleason score,positive surgical margin,seminal vesicle invasion lymph node metastasis and pathological stage were compared between the two groups.Results The median prostate volume of the study group was 45.2 (18.3-121.5) ml,and 47.1 (2 1.3-124.2) ml in the control group.The operation time of the study group was 138.2 (119.5-234.1) mins,and 133.5 (116.8-228.2) mins in the control group.In the control group,there were 8 cases(5.3％) with seminal vesicle invasion,and 8 cases (5.3％) with lymph node metastasis.The pathological stages were pT2-T3 in 145 cases(96.7％),and pT4 in 5 cases (3.3％) in control group.The postoperative Gleason score was 8.0 ± 0.9 in control group.In the study group,17 patients (28.3％) with seminal vesicle invasion were pathologically indicated,and there were 6 patients (10.0％) with lymph node metastasis.The pathological stages were pT2-T3 of 57 cases(95.0％),and pT4 of 3 cases (5.0％),postoperative Gleason score was 7.7 ± 1.0 in study group.There was no statistically significant difference in seminal vesicle invasion,lymph node metastasis,pathological stage and postoperative Gleason score between the two groups (P ＞ 0.05).There were 23 patients (15.3％) with positive margins in the control group,and 28 patients(46.7％) in the study group,which showed significant difference (P ＜0.01).For small lesions,there were 7 cases (4.7％) and 22 cases (36.7％) in the control group and the study group,respectively,which showed significant difference (P ＜ 0.01).There were 17 cases (28.3％) of increased Gleason score in the study group,while 31 cases (20.7％) in the control group,with no statistical difference (P =0.232).Conclusions The whole mount section technique can effectively improve the positive surgical margin and the small lesions detection rate in the pathological evaluation of radical prostatectomy,and provide a precise pathological diagnosis for the postoperative treatment and follow-up of the patients.