Objective To evaluate the clinical value of preserving the intercostobrachial nerve after radical operation for breast carcinoma.Methods The clinical data of patients with breast cancer were analyzed retrospectively,all cases were divided into the observation group and the control group.all cases were followed up after operation from six months to six years in order to observe the abnormal sensation of the skin and the recurrence rate.Results The abnormal sensation of the skin:1 case in the observation group(4.5%),17cases in the control group(73.9%),Two groups have significant difference(x2=20.79 P＜0.01),both groups had not found partial recurrence.Conclusion Preseving the intereostobmchial nerve in modified radical mastectomy for patients with breast cancer,dichat increase the partial recurrence,can increase the life quality of patients after operation,decrease the abnormal sensation of the skin.promote the health both body and mind.

Objective To understand the current situation about flexible position switch of non-licensed nurses in Chongqing, to discuss the cause of the flexible position switch, and to provide basic information for constructing scientific managerial measure. Methods Using the stratified clustering method to sample the nurses from 18 hospitals of different ranks in Chongqing and investigated them with self-designed questionnaire. Results Among the 1145 non- licensed nurses joining the investigation, 42.53%and 52.49% of them showed the will to switch their positions or occupations, 84.89% of them objected their children to occupy themselves with nursing service. 68.56% non-licensed nurses believed that flexible position switching had influence on themselves, while 74.50% of them believed that flexible position switching had impacts on hospitals. The main cause of the flexible position switching of non-licensed nurses included: feeling their work not beyond exceptions、 not enough respect in hospital 、lack of further development, and so on. Conclusions The high rate of will for flexible position switch cause great influences on the development of hospitals and non-licensed nurses themselves. Better treatment and raising respect should be given to them in order to stabilize nursing team.

OBJECTIVE:To evaluate the bioavailability of domestic propylthiouracil enteric coated capsule.METHODS:A modified RP-HPLC assay was used for determination of the plasma drug concentrations.In a randomized two-way crossover design,a single oral dose of100mg domestic propylthiouracil capsule(trial agent,A)and imported propyithiouracil tablet(reference agent,B)were given to20male healthy volunteers.The parameters were fitted by CRFB bioavailaility soft?ware.RESULTS:The AUC 0～t ,C max and t max of A and B were(9.13?1.53)and(8.80?1.37)(?g?h)/ml,(3.02?0.71)and(3.03?0.66)?g/ml,(4.51?0.24)and(1.13?0.44)h respectively.There were no significant differences in parameters between2groups.The relative bioavailability of product A was(104.37?12.16)%.CONCLUSION:The results suggest that these two products were bioequivalent.

Objective To investigate the expression and clinical significance of leptin receptor (OBR) and phosphorylation of signal transducer and activator of transcription (p-STAT3) in patients with diffuse large B-cell lymphoma (DLBCL).Methods Immunohistochemical analysis was used to detect the expression of OBR and p-STAT3 in 80 patients with DLBCL and 10 patients with reactive lymphoid hyperplasia (RLH).Using a panel of immunohistochemical markers (CD10,bcl-6 and Mum-1),all cases of DLBCL were further divided into two groups,GCB (germinal center B-cell-like) or non-GCB.Results Immunohistochemistry revealed high expression of OBR and p-STAT3 in 45.0 ％ (36/80) and 28.8 ％ (23/80) cases of DLBCL,respectively,and minimal straining in 100.0 ％ (10/10) cases of RLH (P ＜ 0.05).Compared with GCB group (8.7 ％,2/23),non-GCB group had higher p-STAT3 high expression rate (36.8 ％,21/57) (P ＜ 0.05).There was no significant difference in the expression of OBR between these two groups.Compared with clinical stage Ⅰ-Ⅱ [46.2 ％ (18/39) and 25.6 ％ (10/39)],stage Ⅲ-Ⅳ had higher OBR and p-STAT3 high expression rate [61.9 ％ (13/21) and 38.1％ (8/21)] (P ＞ 0.05).The expression of OBR and p-STAT3 were not correlated with age,gender,extranodal infiltrations,LDH level,B-symptoms and IPI(international prognostic index)(P ＞ 0.05).The expression of OBR was positively related with that of p-STAT3 in DLBCL patients (r =0.232,P =0.039).Conclusion OBR could stimulate the JAK-STAT signaling pathway and induces the phosphorylation of STAT3.This may be involved in carcinogenesis and prognosis of DLBCL.

OBJECTIVE:To investigate the role of clinical pharmacists on drug therapy for acute exacerbations of chronic ob-structive pulmonary disease(AECOPD)patients with benign prostatic hyperplasia(BPH). METHODS:Clinical pharmacists partici-pated in drug therapy for a AECOPD patient with BPH. According to clinical guideline and relevant literatures,based on the history of disease,the characteristics of bronchodilators and the symptoms of acute urinary retention,it was suggested to stop taking Ip-ratropium bromide solution for inhalation but receive Finasteride capsules 5 mg,po,qd,to reduce prostate volume and improve ob-struction+Terazosin hydrochloride tablets 2 mg,po,qd,to relax urethral smooth muscle;the occurrence of ADR was monitored closely. Salmeterol xinafoate and fluticasone propionate powder for inhalation was suggested and medication guidance for patients af-ter discharge was given by clinical pharmacists. RESULTS:Physicians adopted some suggestions of clinical pharmacists. The pa-tient was stable and had no dysuria. The patient was allowed to leave the hospital with drugs. CONCLUSIONS:Rational use of bronchodilators is directly related to the remission of clinical symptoms and prognosis in AECOPD patients. In view of patient's dis-ease history,drug characteristics and clinical symptoms,clinical pharmacists point to possible risks of anticholinergics use,and as-sist physicians to formulate and adjust therapy plan so as to guarantee the safety and effectiveness of drug use.

Actins ; metabolism ; Aged ; Antigens, Neoplasm ; metabolism ; Carbonic Anhydrase IX ; Carbonic Anhydrases ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Keratin-7 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Nephrectomy ; methods ; Vimentin ; metabolism

Objective To explore the current status of healthcare-associated infection (HAI)and antimicrobial use in a children’s hospital.Methods Prevalence rates of HAI and antimicrobial use among hospitalized patients at 0∶00—24∶00 of May 1 ,2014 were investigated by combination of bedside visiting and medical record reviewing. Results A total of 1 027 patients were investigated,8 patients developed 10 times of infection,prevalence rate of HAI was 0.78%,prevalence case rate was 0.97%.HAI mainly occurred in patients in blood center (n =4),the main infection site was respiratory tract(upper respiratory tract,n=2;lower respiratory tract,n=2),antimicrobial usage rate was 62.12%.Antimicrobial usage rate,purpose of antimicrobial use,and combination use of antimicro-bial agents among different departments were all significantly different(all P <0.05).The departments with top 3 antimicrobial usage rates were neonatal center(89.69%),emergency center(76.00%),and comprehensive depart-ment(73.91 %);except department of ophthalmology-otorhinolaryngology-stomatology (preventive antimicrobial use accounted for 57.89%)and department of surgery(therapeutic antimicrobial use accounted for 26.32%),the other departments mainly used therapeutic antimicrobial agents;department of ophthalmology-otorhinolaryngology-stoma-tology,heart center,and neurological rehabilitation center mainly adopted single medication treatment (all >95%), two-drug combination rate in neonatal center accounted for 48.28%,three-drug combination rate in blood center ac-counted for 30.30%.Conclusion Routine surveillance on departments and sites of high HAI incidence should be in-tensified in children’s hospitals,training on knowledge of HAI among health care workers should be strengthened, and antimicrobial should be used rationally.

Objective To explore the infection rate of hepadnaviruses and non-hepatotropic virus in infants with biliary atresia(BA)and their relationship between the onset and development of BA.Methods The data and pathogen test records from 184 BA infants who were hospitalized at Guangzhou Women and Children's Medical Center from January 1,2010 to December 31,2014 were reviewed,and the infection rates caused by 3 hepadnaviruses including hepatitis A virus(HAV),hepatitis B virus(HBV),hepatitis E virus(HEV)as well as 5 non-hepatotropic viruses including cytomegalovirus(CMV),Epstein-Barr virus(EBV),herpes simplex virus(HSV),enterovirus(EV),Coxsackie-virus were analyzed.The outpatients or inpatients without BA and immunodeficiency were selected as controls.Results In BA patients,the infection rates of CMV were highest(40.21％,39/97 cases)caused by 3 hepadnaviruses(HAV,HBV,HEV)and 5 non-hepatotropic viruses(CMV,EBV,HSV,EV,Cox),while the infection rates of HAV,HEV,HBV,EBV,HSV,EV or Coxsackievirus were all low,and mixed virus infection was found in 9 patients.The positive rate of CMV IgM in BA group[34.94％(29/83 cases)] was significantly higher than that in the control group[15.69％(8/51 cases)],and the difference was statistically significant(x2=5.86,P<0.05);and the positive rate of CMV DNA in BA group[28.57％(20/70 cases)] was significantly higher than that in the control group[3.70％(1/27 cases)],and the difference was statistically significant(x2=7.10,P<0.05).In BA infants under 60 days,the detection rate of CMV DNA was 45.45％(15/33 cases),which was higher than that in the ones over 60 days[25.48％(5/37 cases)],and the difference was statistically significant(x2=8.72,P<0.01);while the positive rate of CMV IgM had no significant difference among≤60 d group,60-90 d group and ≥90 d group[47.22％(17/36 cases),20.00％(6/30 cases),35.29％(6/17 cases)](x2=5.62,P>0.05).No statistical difference in age was found in BA patients on detection between the positive and the negative group,and the consistency of CMV DNA and CMV IgM was not ideal(Kappa value<0.4).Conclusions Infection of CMV is quite common in BA patients,BA infants under 60 days old show higher detection rate of CMV DNA than the older ones,but there is no difference in detection rate of CMV IgM among different ages,CMV is not supported as a secondary infection and may play a role in the occurrence and development of BA.

Objective : To identify biomarkers for esophageal squamous cell carcinoma (ESCC) using bioinformatics tools, so as to provide insights into diagnosis and targeted therapy of ESCC. Methods: The gene expression datasets GSE23400, GSE45670, GSE20347 and GSE17351 were screened and downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) of ESCC were screened using the online tool GEO2R, and the common DEGs among the four datasets were determined using Venn diagram. Gene Ontology (GO) annotations and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed using the DAVID database, and protein-protein interaction (PPI) analysis was performed using the STRING database. The key modules were identified using molecular complex detection (MCODE) plugin in the Cytoscape software, and hub genes with the highest connectivity degree were identified using the CytoHubba plugin, and the gene expression was validated on the UALCAN platform. Survival analysis of hub genes was performed using the Kaplan-Meier plotter database. Results: Totally 146 common DEGs were screened, including 102 up-regulated genes and 44 down-regulated genes. GO annotation analysis showed that the common DEGs were mainly enriched in biological processes of cell cycle, sister chromatid separation in the late mitotic phase and cell cycle regulation, enriched in cellular components of spindle and centrosome, and molecular functions of enzyme binding and ATP binding. KEGG pathway analysis showed that DEGs was significantly enriched in cell cycle, extracellular matrix (ECM)-receptor interactions and oocyte meiosis. A total of 10 hub genes were screened, and gene expression validation and survival analysis identified 7 genes associated with prognosis of ESCC, including CCNB1, CDK1, BUB1B, ZWINT, AURKA, MAD2L1 and MCM4, which were all highly expressed in ESCC specimens. Conclusion Seven hub genes of ESCC are identified based on bioinformatics, which may serve as biomarkers and therapeutic targets for ESCC.

ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.