The common care security risks in rehabilitation ward are summarized. The effective preventive measures are proposed.

Personalized medicine has revolutionized patients ′care, and results in a personalized drug choice and dosage, through integration of pharmacology , drug information and individual ′s genetics information.The genetic testing for genes involved in drug metabolisms and targets become more and more important.However, the variety of the tests as well as the complexity of the technology brought great challenges in laboratory managements and quality assurance for individual clinical laboratory .This article briefly described the development status of pharmacogenomics and focused mainly on the routine quality assurance principle for four different techniques adopted by related genetic testing , and then presented recent research progression of related reference materials in genetic testing .Finally, the author prospects briefly the future development aspect of the quality control system .

OBJECTIVETo study the effect of Compound Ezhu Powder (CEP) on serum levels of CA125 and CA19-9, and the expression of cyclin D protein in endometriosis patients, thus providing theoretical evidence for clinical application of CEP.

METHODSTotally 69 all endometriosis patients underwent surgical treatment at Department of Gynecology and Obstetrics, Tianjin Nankai Hospital from January 2011 to January 2013 were randomly assigned to group A (35 cases) and group B (34 cases). Meanwhile, 30 patients with uterine fibroids who prepared for surgical treatment during the same period were recruited as the control group. Patients in group A took EZP 3 months before surgery. No treatment was given to patients in group B and the control group. The serum CA125 level and the expression of cyclin D in the ectopic endometrium and the eutopic endometrium were detected in the 3 groups before surgery.

RESULTSThe expression of cyclin D was higher in group A and group B than in the control group (P < 0.05). The serum levels of CA125 and CA19-9 were significantly lower in group A than in group B (P < 0.05). The expression of cyclin D in the ectopic endometrium was lower in group A than in group B, but with no statistical difference (P > 0.05). The expression of cyclin D in the eutopic endometrium was significantly lower in group A than in group B with statistical difference (P < 0.05). Meanwhile, the serum CA125 level was positively correlated with the serum CA19-9 level (r = 0.45, P < 0.05).

CONCLUSIONSThe expression of cyclin D obviously increased in endometriosis patients, which was associated with the occurrence of endometriosis. CEP could lower serum levels of CA125 and CA19-9, and down-regulate the expression level of cyclin D, indicating its roles in inhibiting the cell cycle.

Adult ; Antigens, Tumor-Associated, Carbohydrate ; blood ; CA-125 Antigen ; blood ; CA-19-9 Antigen ; blood ; Cyclin D1 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Endometriosis ; blood ; drug therapy ; Female ; Humans

Objective To explore the diagnosis and treatment of gluten-related disorders (GRD).Methods Anti-gliadin antibodies (AGA),anti-tissue transglutaminase (tTG) antibody,deamidated gliadin peptides(DGP) antibody and serum specific IgG antibodies of 14 kinds of intolerable food were tested in people who developed chronic diarrhea after the intake of gluten diet.HLA-DQ2,HLA-DQ8 and intestinal endoscopic multiple biopsies would be performed further in patients with positive coeliac disease (CD)-specific serology.Gluten free diet was given to patients with positive CD-specific serology.One patient received prednisone (30 mg/d and diminished 5 rmg/w).Results Nine patients were confirmed with celiac disease(CD) and four cases were suspected non-coeliac gluten sensitivity (NCGS) in 13 patients with positive serologic tests.Twelve cases received effective therapy.In CD group,6 cases were accompanied with comorbidities mainly autoimmune diseases and osteoporosis.The positive rates of AGA and tTG antibody were 9/9 and 2/9 respectively in the CD group,while tTG antibody in the NCGS group were both negative.Endoscopic intestinal biopsy was performed in all 13 cases.Plasma cell proliferation and lymphocyte infiltration in the lamina propria without villus atrophy were identified in 4 cases,representing chronic inflammation of the small intestine.Villus atrophy was detected in 9 cases.Two patients with NCGS ingested gluten after 4 and 6 months of gluten-free diet respectively,and the number of bowel movements increased 1-2 times per day.Conclusions The diagnosis of CD is mainly based on serologic tests and characteristic of histological features.CD may be companied by other autoimmune diseases or metabolic disease of bone.Lifelong adherence to a gluten free diet is the most basic and effective therapy.

Acupuncture Therapy ; Adult ; Female ; Humans ; Thyroid Neoplasms ; surgery ; therapy

Carcinoma in Situ ; pathology ; virology ; Carcinoma, Squamous Cell ; pathology ; virology ; Diagnosis, Differential ; Female ; Humans ; Paget Disease, Extramammary ; pathology ; virology ; Papillomavirus Infections ; Precancerous Conditions ; pathology ; virology ; Vulvar Neoplasms ; classification ; pathology ; virology ; Warts ; pathology ; virology

ObjectiveTo discuss the application of clinical pathway in the health education for spinal cord injured patients in rehabilitation department. Methods56 patients with spinal cord injury were divided into 2 groups: treatment group and control group. Both groups were cared with holistic nursing. However, the health education to the treatment group was given by clinical pathway, while to the control group by traditional way. On the day of discharge, the health education standard and the satisfaction of patients were investigated. ResultsBoth the rates of standard in health education and satisfaction were more in treatment group than in control group. ConclusionApplication of clinical pathway can regulate the health educational behavior, improve the communication between nurses and patients, and the quality of nursing.

Diagnosis, Differential ; Endophthalmitis ; diagnosis ; diagnostic imaging ; etiology ; pathology ; Humans ; Infant, Newborn ; Male ; Meningoencephalitis ; complications ; diagnosis ; diagnostic imaging ; pathology ; Suppuration ; Tomography, X-Ray Computed

BACKGROUND:Cytological studies show that bone marrow mesenchymal stem cel s play an important role in postmenopausal osteoporosis mechanism.
OBJECTIVE:To study the osteogenic differentiation in vitro of bone marrow mesenchymal stem cel s from ovariectomied osteoporotic rats.
METHODS:The osteoporotic animal model was established by performing ovariectomy in the 6-month-old female Sprague-Dawley rats. There were four groups:bone marrow mesenchymal stem cel s control group, bone marrow mesenchymal stem cel s osteoporosis group, bone marrow mesenchymal stem cel s osteogenic induction group and oseogenesis induction group. Bone marrow mesenchymal stem cel s were isolated from the rats of control group and oseogenesis induction group by means of the whole bone marrow adherence method and cultured to the 3rd generation. Then the bone marrow mesenchymal stem cel s were used in al the experiments. Cel morphology was observed under the inverted phase contrast microscope, cel cycle and proliferation index of bone marrow mesenchymal stem cel s were detected by flow cytometry. After osteogenic induction, the expression level of alkaline phosphatase was detected, and the fornation of calcium nodes of bone marrow mesenchymal stem cel s were marked by alizarin red staining.
RESULTS AND CONCLUSION:The cel s in the osteogenic induction group and oseogenesis induction group had the morphology of osteobalsts, and the change of morphology of the cel s in the oseogenesis induction group was relatively tardiness. The proliferation index in the control group was higher than that in the osteoporosis group (P<0.05);expression level of alkaline phosphatase in the osteogenic induction group was significantly higher than that in the oseogenesis induction group (P<0. 05), and the control group was significantly higher than the oseogenesis group (P<0.05). The alizarin red staining of the cel s in the osteogenic induction group was positive, while negative in the control group and the oseogenesis group;the staining in the osteogenic induction group was stronger than that in the oseogenesis induction group. These findings indicate that both the proliferative potential and the osteogenic potential of bone marrow mesenchymal stem cel s from the ovariectomized osteoporotic rats are decreased, which may be related with the ostoeporosis pathogensis of ovariectomied rats.

Objective To evaluate the efficacy of pressure-controlled volume-guaranteed (PCVVG) mode for lung protective ventilation in patients requiring one-lung ventilation (OLV) during thoracoscopic surgery.Methods Sixty patients,aged 50-70 yr,with body mass index of 18-26 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of esophageal cancer performed via video-assisted thoracoscope under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:volume-controlled ventilation group (group V) and PCV-VG group (group P).The ventilator settings were adjusted,with a tidal volume 10 ml/kg and respiratory rate 10-12 breaths/min during two-lung ventilation,and with a tidal volume 6 ml/kg and respiratory rate 12-16 breaths/min during OLV.The inspiratory/expiratory ratio was 1 ∶ 2,pressure restriction was 35 cmH2O,and 33％ oxygen was inhaled at 2 L/min.The end-tidal pressure of carbon dioxide was maintained at 35-40 mmHg.Visual analog scale score was maintained ≤ 3 after operation.After admission to the operation room (T0) and at 1,3 and 7 days after operation (T1-3),forced vital capacity (FVC),forced expiratory volume in first second (FEV1),and maximal mid-expiratory flow (MMEF) were measured,arterial blood samples were collected for blood gas analysis,arterial carbon dioxide partial pressure and arterial oxygen partial pressure (PaO2) were recorded,and alveolar-arterial oxygen tension difference (PA-a O2) was calculated.Clinical Pulmonary Infection Score was assessed at T1,T2 and T3.The chest tube removal time and length of postoperative hospital stay were recorded.Results Compared with the baseline at T0,FVC,FEV1,MMEF and PaO2 were significantly decreased,and PA-aO2 was increased at T1-3 in the two groups (P＜0.05).Compared with group V,FVC,FEV1,MMEF and PaO2 were significantly increased,PA-aO2 and Clinical Pulmonary Infection Score were decreased,and the chest tube removal time and length of postoperative hospital stay were shortened at T1-3 in group P (P＜0.05).Conclusion PCV-VG mode can achieve lung protective ventilation,which is helpful in improving outcomes in the patients requiring OLV during thoracoscopic surgery.