Objective To establish an HPLC method for the determination of 2, 3, 5, 4'-teterahydroxystibene-2-O-?-D-glucoside in Yangyan Pills. Methods HPLC was carried out on a C18 column, using mobile phase of acetonitril-water(25 ∶ 75), and detection wavelength was 320nm. Results The 2, 3, 5, 4'-teterahydroxystibene-2-O-?-D-glucoside sample showed a good linear relationship at the range of 0.05～ 0.40 mg/mL, r=0.999 9. The average recovery was 99.7 % (n=9), and RSD was 0.31 % (n=9). Conclusion The method was simple, available and accurate.

Objective To analyze factors influencing β-blocker response rates of patients with portal hypertension and to explore the effect of nursing interference for increasing response rates with goal-directed nursing model. Methods 83 cases of portal hypertension were enrolled.Questionnaire about medical visiting behaviors and medication compliance were compared and analyzed after routine medication for 3 months.Bivariate and multivariate regression analysis were performed and related factors were used to establish a goal-directed nursing model for nursing interference guidance.52 non-response patients were randomly divided into the study group(27 cases)and the control group(25 cases).In the study group,compensation system and supportive-education according to Orem model were given,while the control group was given routine nursirng.Response rates and related factors were compared after 3 months of nursing intervention. Results Awareness of self-care responsibility,knowledge about the medication target,risk of sudden drug withdrawal,related medical knowledge,ability for pulse rate measurement and dose adjustment according to pulse rate changes were related to the response rates.Multivariate regression analysis showed that awareness of self-care responsibility,sudden drug withdrawal,utilization of social support and regular return visit were the independent factors.In the study group,ability for pulse rate measurement and dose adjustment acconding to pulse rate changes improved,phenomenon of sudden drug withdrawal declined and response rate increased,comparing with the control grpup. Conclusins For patients fail to respond to β-blockers,compliance behavior and medication compliance should be analyzed,and much attention should be paid to the education of the related medical knowledge,risk of sudden drug withdrawal and drag using targets.Goal-directed medel could be a guidance for nursing intervention to increase the response rates.

Objective To investigate the roles of fiberoptic bronchoscopy in diagnosis and treatment for infants with refractory and persistent wheezing. Methods From Jun. 2012 to Dec. 2013, 52 hospitalized children with age between four 4 months and 1 year old were recruited for ifberoptic bronchoscopy, who had been wheezing for at least four weeks and treated ineffectively with conventional anti-inlfammatory agents:budesonide and compound ipratropium bromide solution. Then, the pathogenesis of refractory and persistent wheezing was summarized based on clinical features, detection of CT imaging of three-dimensional airway reconstruction and cardiac CT, results of bronchoscopy inspection, and bronchoalveolar lavage lfuid culture. Results Among the 52 cases, 40 were with ground glass-like changes (76.92%) in pulmonary spiral CT testing, 4 with mosaic perfusion syndrome (7.69%), 8 with segmental pulmonary consolidation (15.38%), 8 with obstructive pulmonary emphysema (15.38%), and 1 with left primary bronchial foreign body. In addition, through bronchofibroscopy, there were 52 cases with imlfammation (100%),3 with tracheal stenosis (5.77%), 3 with left and/or right main bronchus stenosis of the external pressure, 18 with bronchomalacia(34.62%), 2 cases with foreign body (3.84%), one in trachea (1.92%), the other in left main bronchus (1.92%), 10 with bronchial mucus plug (19.23%), and 8 (15.38%) with congenital airway malformations (including 3 at tracheal bronchus, 1 at left upper lobe bronchial stenosis and 1 at bronchial Bridge). The culture of bronchoalveolar lavage lfuid were conducted for all patients. The positive rate of bronchoalveolar lavage lfuid was 9.62%(5/52 cases), including 2 cases with tip Escherichia coli, 2 with Haemophilus inlfuenzae, and 1 with Acinetobacter baumannii. Conclusions First, infection is the primary cause of refractory and persistent wheezing, which is persistent in airway resulted from multi-drug resistant bacteriua. Second, refractory and persistent wheezing is often caused by multi-factors including infection, congenital airway malformations, the endogenous and exogenous foreign body, cardiovascular malformation, etc. These factors often lead to dififcult wheezing control. The last, the diagnosis rate of the refractory and persistent wheezing can be improved by combination of ifberoptic bronchoscopy and lung spiral CT.

OBJECTIVE To isolate bacteria from three second-class hospitals in Zhenjiang Jiangsu Provine,to detect their drug(-resistance) to antibacterial(agents) and analyzed the results in order to find out pathogen distribution and drug(-resistance) trend of the common causative organism.METHODS We isolated 1661 strains of bacteria from clinical samples between 2002 and 2004,and analyze their drug-resistance.RESULTS The number of Gram-positive(bacteria) was 634,accounting for 38.2%,from them there were 312 strains of coagulase-negative Staphylococcus epidermidis,and 148(coagulase)-positive S.aureus.Drug-fast of two above staphylococci was similar.The(resistance) rate to penicillin and to oxacillin surpassed 85%,that to erythromycins exceeded 75%,to quinolones and cephalosporins surpassed 30% and 35%,respectively.The resistance rate to(vancomycin) was zero.Gram-(negative) bacteria were 1 027 strains,accounted for 61.8%.(According) to quantity order,the first was Enterobacter(249 strains);then were Klebsiella(226 strains);Escherichia(167 strains);Pseudomonas aeruginosa(136 strains);and Proteus(62 strains).The resistant rate to semisyhthesized penicillins among the first five Gram-(negative) bacteria species,was the most,especially the Proteus.CONCLUSIONS Clinical doctors,the(laboratorians) and detecting infection department in hospital should markedly pay attention to drug-resistant(bacterium) detection,pathogen mutation and drug-resistance trend,in(order) to reasonably use antibacterial(agents).

OBJECTIVE To find out about the transverse section use rate of antimicrobials in our hospital. METHODS A transverse section survey was made from midnight on June 24,2004 to midnight on June 25,2004 within all the inpatients. RESULTS Among 1132 inpatients,the transverse section use rate of antimicrobials was 58.83%,the combined medication ratio being 34.08%.Of all antimicrobial takers 65.92% were given single drug,31.68% double,and 2.40% were given triple.Among all departments of the hospital,the universal ICU had the highest use rate which was 100.00%,next to which were those in the departments of nephrology and gynecology,being respectively 90.00% and 87.23%.The antimicrobial use rate in surgical department(69.68%) was remarkably higher than that in medical department(43.08%).The departments of ophthalmology and otorhinolaryngology had the highest prophylactic use rate which was 83.64%.Rate of etiological examination for therapeutic medication in the whole hospital was 35.97%. CONCLUSIONS The transverse section use rate of antimicrobial in our hospital is slightly higher than the national average use rate.The constituent ratio of prophylactic medication is on the high side and the rate of etiological examination for therapeutic medication is on the low side.Management should be further strengthened for rational use of antimicrobials.

Objective To study the prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy and to analyze its influencing factors .Methods One hundred and fifty patients with distant metastasis after nasopha-ryngeal carcinoma radical radiotherapy were followed up .Their clinical data were collected to conduct the prognosis analysis and in-fluencing factors analysis .Results The median survival time in the follow up cases was 13 .50 months ,the one-year survival rate was 49 .8% ,two-year survival rate was 31 .0% and three-year survival rate was 19 .3% .The Cox model single factors analysis re-sults showed that the N stage in initial diagnosis ,whether conducting chemotherapy in initial diagnosis ,time interval from radiother-apy finish to distant metastasis occurrence ,metastasis site ,chemotherapy after distant metastasis ,chemotherapy cycles and palliative radiotherapy were the prognosis related influencing factors (P<0 .05) ,in which the N stage ,metastatic site ,chemotherapy after dis-tant metastasis ,time interval from radiotherapy finish to distant metastasis occurrence and palliative radiotherapy were the inde-pendent influencing factors of prognosis(P<0 .05) .Conclusion The independent factors of prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy are the N stage at initial diagnosis ,metastatic site ,whether having chemotherapy after distant metastasis ,time interval from radiotherapy finish to distant metastasis occurrence and whether conduc-ting the palliative radiotherapy .

Objective To investigate the application of new portable vein visualizer in venous indwelling needle puncture in children.Methods A total of 432 children from January 2016 to June 2016 in pediatric department were randomly divided into observation group (n=224) and control group (n=208). Children in observation group received self-designed new portable vein visualizer in superficial venous indwelling needle puncture, while children in control group received traditional needle puncture. The one-time puncture success rate, puncture time, pain in children and family satisfaction were compared between two groups.Results The success rate of observation group (95.1%) was significantly higher than control group (73.1%) (χ2=39.881, P<0.05). The puncture time of observation group was shorter (3.400±0.615) than control group (4.850±0.873), with statistically significant difference (t=9.608,P<0.05). The family satisfaction in observation group (96.1%) was significantly higher than control group (85.2%) (χ2=7.037,P<0.05).Conclusions Application of new portable vein visualizer in superficial venous indwelling needle puncture in children improves the success rate, decreases the puncture time, reduces the pain of children and improves family satisfaction.

Objective By investigating the effects of miR-379-5p on the proliferation,invasion and metastasis of mouse breast cancer 4T1 cells,we aimed to provide new therapeutic targets for the clinical inhibition of breast cancer proliferation,invasion,and metastasis.Methods After plasmid transfection,4T1 cells were utilized to detect the expression of miR-379-5p using fluorescence quantitative PCR.While 5-ethynyl-2'doxyuridine(EdU)cell proliferation and Transwell assays were employed to detect changes in the proliferation and invasion ability of 4T1 cells in each group.The migration ability of 4T1 cells after overexpression and knockdown of miR-379-5p was examined by scratch healing assay.A transplanted tumor model of breast cancer was established in BABL/c mice,and the effects of overexpressing miR-379-5p on tumor growth and the number and size of lung metastases were observed.Results EdU result showed that knocking down miR-379-5p enhanced the proliferation ability of the cells compared with the control group cells,and miR-379-5p overexpression reduced the capacity of breast cancer cells to proliferate(P＜0.05).Transwell and wound healing assays showed that miR-379-5p knockdown enhanced,while miR-379-5p overexpression significantly inhibited,the invasion and migratory ability of breast cancer cells(P＜0.01).An in vivo tumorigenesis experiment with BABL/c mice showed that miR-379-5p overexpression significantly slowed the tumor growth rate(P＜0.05)and inhibited lung metastasis(P＜0.01).Conclusions MiR-379-5p plays a role in tumor gene suppression in breast cancer and inhibits the proliferation,invasion,and migration of mouse breast cancer 4T1 cells.

OBJECTIVETo explore the pathological features and prognosis of appendiceal mucinous neoplasms (AMN) based on WHO classification 2010.

METHODSSeventy consecutive cases of AMN were classified into 5 groups according to WHO classification of digestive system tumors in 2010 including mucinous adenomas/cystadenoma (MA), low grade appendiceal mucinous neoplasms (LAMN), low grade pseudomyxoma peritoneum originated from appendix (PMP-L), invasive mucinous adenocarcinomas (MAC) and high grade pseudomyxoma peritoneum originated from appendix (PMP-H). Clinicopathological features, classification, treatment and prognosis of AMN were investigated retrospectively.

RESULTSThere were 11 cases of MA with neoplastic epithelium and mucin being defined in lumen and mucosa but without invasive lesions, and no relapse or death was found. In 41 LAMN cases, mucin was found in submucosa, muscularis proparis, or serosa of appendix, no or only scant mucinous epithelium with low grade dysplasia presented in mucinous pools in most cases (39/41). Among 41 LAMN cases, 3 developed relapse or PMP-L, and no death was observed. In 7 PMP-L cases, low grade dysplastic mucinous epithelium in mucinous pools could be found easily in 3 cases and was very scanty in 4 cases, with 1 relapse and 1 death. Eleven invasive carcinomas were found, including 7 MAC cases and 4 PMP-H cases, with local high grade dysplastic epithelium at least. In these invasive lesions, 4 cases recurred and 3 case died (including 2 recurred cases above). MA and LAMN were both non-invasive neoplasms histologically, however, PMP-L, MAC and PMP-H were regarded as adenocarcinomas according to their biological behavior.

CONCLUSIONAMN displays a relatively homogeneous group of neoplasms that pursues a predictable clinical course based on their nature, so it is necessary to diagnose and administrative accurately with consistently standards for these neoplastic entities.

Adenocarcinoma, Mucinous ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Appendiceal Neoplasms ; classification ; pathology ; Child ; Female ; Humans ; Male ; Middle Aged ; Myxoma ; pathology ; Prognosis ; Young Adult

Background: Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. Methods: Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P<0.001). Most of the guidelines advocated systolic BP targets <130 mm Hg (12 guidelines, 60%) and diastolic BP targets <80 mm Hg (14 guidelines, 70%) in DM patients. Approximately half of the guidelines supported systolic BP thresholds >140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. Conclusion The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.