Volume overload or hidden lung congestion is emerging as a pervasive problem in end-stage renal disease (ESRD) patients on hemodialysis,which will lead to cardiovascular complications and impact the patients' life quality and survival time,so how to improve volume control in patients on hemodialysis is a urgent research hotspot.Recently,the ap plication of lung ultrasound for semi-quantitative assessment pulmonary congestion in patients on hemodialysis has received general concern.Lung ultrasound not only can detect excessive extravascular lung water in the early period of pulmonary congestion,but also can predict cardiac events and mortality in ESRD.Lung ultrasound is an effective,sensitive,real-time and non-invasive tool beside.The application and progresses of lung ultrasound in evaluation of pulmonary congestion in hemodialysis patients were reviewed in this article.

Objective: According to the medical system reform’s requirement of “strengthening supervision, increasing the public health investment, reforming the compensation mechanism of public hospital, establishing public hospital performance evaluation and incentive system”, public hospitals should continue to reform its management system optimization, performance appraisal is the core content of hospital internal reform performance appraisal method, which is an important guarantee for the results of hospital performance evaluation. Methods: The study on the assessment methods of hospital performance, use “public hospital”, “performance” and“performance evaluation” as the keywords to search the Chinese HowNet and Wanfang database retrieval and 142 articles; by reading the whole passage and the method of stratified sampling, the common performance appraisal method are used to collect and collate, eventually the assessment method of hospital performance of 32 Chinese literature references are included in the study. Results:Summarize the evaluation methods of hospital performance application condition advantages, disadvantages and present situation, and establish a set of performance evaluation methods with the management of public hospitals more perfect, scientific and detailed theoretical basis. Conclusion: In the process of the medical system reform, according to the characteristics of hospitals, to choose suitable and effective performance appraisal methods to help the performance management in hospital, and receive more economic benefits while maximize social benefits.

OBJECTIVE: To investigate the influence of signal transducer and activator of transcription 3 (Stat3) and hypoxia-inducible factor-lα (HIF-1α) on the resistance effect of laryngeal squamous cell carcinoma to radiation therapy and chemotherapy under the hypoxia circumstances. METHOD: Western blot was used to test the expression of p-Stat3 and HIF-1α in the Hep-2 cells under the hypoxia conditions. MTT assay was used to test the proliferation of Hep-2 cells after radiation therapy and chemotherapy; the Hep-2 cells were suppressed expression of Stat3 and/or HIF-1α. RESULT: (1) AG490 induced significant proliferation inhibition on Hep-2 cells and Hep-2HIF-1α-/- cells in vitro underthe hypoxia environments (P < 0.05); (2) Suppressing expression of Stat3 reduced the expression of HIF-1α protein (P < 0.05); (3) Combined inhibition of Stat3 and HIF-1α enhanced radio- and chemo-sensitivity in laryngeal squamous carcinoma cells under hypoxia. CONCLUSION Combined inhibition of Stat3 and HIF-1α can further enhance radio- and chemo-sensitivity in laryngeal squamous carcinoma cells under hypixia compare than inhibiting Stat3 or HIF-1α alone. Effectively blocking of HIF-1α pathway and suppressing the expression of Stat3, would be an effective method to enhance radio- and chemo-sensitivity in laryngeal squamous carcinoma cells, which provides a new thought to reduce the resistance to treatment.
Blotting, Western ; Carcinoma, Squamous Cell ; Cell Hypoxia ; Cell Line, Tumor ; Humans ; Hypoxia ; Hypoxia-Inducible Factor 1, alpha Subunit ; Laryngeal Neoplasms ; STAT3 Transcription Factor

Objective To investigate the clinic characteristics,therapeutical approaches and outcome of food-borne infection caused by Group C,Type? hemolytic streptococcus.Methods We retrospectively analyzed 51 patients infected by Group C,Type? hemolytic streptococcus who were hospitalized in the First Hospital of Hebei Medical University from May to June 2003.Results All the patients had eaten the same food which was infected by Group C,Type ? hemolytic streptococcus.The clinical manifestations were 51 pharyngal hyperaemia(100%),44 fever(86%),39 tonsillitis(76.5%),31 headache(60.8%)and 23 ache from head to foot(45.1%).There was no obvious digestive symptom.Seventeen cultivated pharyngal swab samples had all positive results,and 23(52.3%)of 44 cultivated collutory samples were positive.The cultivated bacteria were all Group C,Type? hemolytic streptococcus equisimilies.All the patients were cured after antimicrobial therapy,and hadn't get any complication.Conclusion Infection caused by Group C,Type? hemolytic streptococcus should be considered if the patients have the same food and have such symptoms as fever,headache,ache from head to foot,pharyngal hyperaemia and tonsillitis.Diagnosis can be confirmed with the positive cultivated result of pharyngal swab and collutory.The patients without serious basic disease will have good prognosis after effective and timely therapy.

To search the effective health education to the hypertension patients and to decrease complication such as cerebrovascular ailment,106 hypertension patients were divided into two groups randomly:the interference (52) and the control (54).The interference group is treated with health education and health promotion constantly (Base line:1996,end line 1999).The results of 2 times investigations at the base line and end line respectively to the groups show that:the KAB in both groups were improved,and the interference improved notably,especially in behavior.The percentage of the patients who care about danger factors and hygeine knowledge rise from 68% (base line) to 78.6% and the percentage of the patients who did exercise constantly rise from 58.9% to 71.4%.It is also showed that,in periodic measurement of blood pressure and regular administration of medicine,the interference group behaved better than the contrast (P<0.01).We can conclude that giving face to face health education and health promotion to hypertension patients is a effective way to prevent and control hypertension complications

Objective To investigate any correlation between diffusion tensor imaging (DTI) results and Montreal cognitive assessment (MoCA) scores after severe traumatic brain injury (TBI).Methods Eight male pa-tients with chronic severe TBI were given the MoCA (including memory,attention,speech and executive function).DTI was used to quantify the fractional anisotropy (FA) of white matter fiber tracts in the radial and longitudinal fasciculus,under longitudinal fasciculus,internal capsule,corpus callosum genu and body,and the cingulate cortex.Pearson correlation coefficients were calculated to quantify the correlation between the FA values and MoCA scores.Results There was a positive correlation between FA in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus and MoCA total scores.Conclusion The MoCA scores of patients with chronic severe TBI are related to white matter damage in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus.

Objective To analyze the clinical characteristics of children with cyclic vomiting syndrome (CVS), summarize the clinical experience, and improve the awareness,diagnosis and treatment level of CVS.Methods The clinical data and results of long-term follow-up of the children with CVS were collected and analyzed from 1995 to 2009 in our department.Results Forty-six children were enrolled in the study, including 22 boys and 24 girls.Mean onset age was 4.5 years(ranged from 1 to 11 years)and the mean age at final diagnosis was 8.5 years (ranged from 4.5 to 14.5 years).Sixty-six and seventy-four percent of patients had family history of migraine and motional sickness respectively,whereas 83% patients had triggers.The clinical manifestation of CVS was severe episodic vomiting.The episodes had a rapid onset and sudden ending,persisted for several hours to days,and were separated by symptom-free intervals.The incidental symptoms were pallor, lethargy,intractable nausea,abdominal pain,headache,photophobia and dizzy.Twenty-nine patients diagnosed were followed up for 5 years at average.Five patients were treated with valproate,4 with cyproheptadine, 5 with cyproheptadine and valproate,5 with amitriptyline,cyprohep tadine and valproate,and 3 with cyproheptadine and flunarizine.All treated patients recovered mean 10 months(1.5 months to 2 years) years later and displayed the reduced number of episodes or the severity of episodes except 3 patients.Twenty-eight percent (8/29) of patients progressed to migraine headaches.Conclusion CVS is a relatively common disease in children and awareness of the condition should be increased.CVS should be considered when patients had recurrent vomitting and were completely healthy between the two episodes after excluding other pathological conditions.

Objective To investigate the prevalence and characteristics of thyroid nodule and its relationship with thyroid function in a group of middle-aged to elderly individuals.Methods A cross-sectional,stratified,and cluster random sampling study was performed in 1 721 subjects (average age 71.4 years,from 40 to 108 years).All subjects underwent ultrasound thyroid scan,and the prevalence of thyroid nodule and its size,quantity,property,and distribution were age-stratified and analyzed.The relationship between nodule existence and thyroid function was assessed in subjects who randomly accepted TSH,FT4,and FT3 tests.Results The prevalence of thyroid nodule reached to 76.6％.The incidence of nodule increased with age (x2 =92.08,P＜0.01),and was more common in female (87.4％ vs 75.5％,P =0.001).In patients with thyroid nodule,the prevalence of solitary nodule was 25％,compared with 75％ of multiple nodules,which increased with age (x2 =78.55,P＜0.01).The prevalence of small nodule reached to 68.2％,compared with 31.8％ of large nodules,which also increased with age (x2 =36.82,P＜0.01).As to the property of nodule,solid nodule was the most common form (72.3 ％),cyst-solid nodule accounted for 26.6％,and detection rate of cyst nodule was only 2.1％,and there was no significant difference among the different age groups (x2 =14.22,P=0.076).884 among the total subjects underwent thyroid function test,multiple logistic regression analysis demonstrated that the reduction of TSH was the only independent predicting factor of thyroid nodule (P =0.005).Conclusions The prevalence of thyroid nodules was considerably high according to the examing of ultrasonographic image,especially in the elderly.The incidence of thyroid nodule,especially multiple nodules or larger nodule,increased with age and solid nodule was the most common finding.

Objective To explore the relationship of serum level of Cystatin C and suPAR with tumor infiltration, metastasis, and treatment of patients with malignant tumor. Methods: The serum levels of Cystatin C was detected by particle enhanced nephelometic immunoassay (PENIA) by 7600-010 full-automatic biochemical analyzer made in Japan. The level of suPAR was detected by ELISA. The serum levels of Cystatin C and suPARof 82 normal adults and 172 patients with malignant tumor were measured and compared. Results: The serum level of Cystatin C and suPAR in patients with malignant tumor was significantly increased compared with that of normal adults (P＜0.01 and P＜0.01). The level of Cystatin C and suPAR in terminally ill patients or patients with metastasis was significantly higher than that in the control group. The levels of the two indices in postoperative patients were lower than those in preoperative patients. No significant difference was found in the levels of the two indicies before chemotherapy or radiotherapy and after therapy. Conclusion: The serum levels of Cystatin C and suPARin patients with malignant tumor are correlated with tumor invasion, metastasis and surgical intervention. Detection of Cystatin C and suPAR levels in patients with malignant tumor is valuable for disease monitoring and treatment evaluation.

Objective:To analyze the time consumption in the review of multicenter clinical trials and to explore the methods of improving the approval efficiency.Methods:We retrospectively analyzed 246 multicenter clinical trials approved by our hospital from 2012.Group A were trials that our hospital was the leading site while group B were those not.In group B,trials were divided into group B1 (conference review) and B2 (expeditedreview)according to the ethical review methods.Each group's ethical review time,contract signature time,starting experiment time,the total time consumption of review,and the time from the leading site approving to the participating site submitting application were analyzed.Results:In the review of multicenter clinical trials,contract signature cost the most time,accounting for 41％.There was no significant difference in terms of whether to be the leading site.The total time consumption of group B1 and group B2 was 180.94 days and 140.36 days (P ＜0.05),respec tively.The average ethical review time of group B1 was about 20 days longer than group B2 (P ＜ 0.01).There were 96.54 days that the leading site submitted review materials to the participating site after approved.Conclusions:In multicenter clinical trials,for those the leading site has already approved,immediate submission to participating site and choosing the expedited review method may improve the ethical review efficiency,thereby shorten the total approval time consumption.