BACKGROUND: With the development of China, quality of life (QOL) is getting more and more attention, however, there are few studies on QOL, especially in Mainland China.OBJECTIVE: To observe the situation of combinative application of Functional Independence Measure (FIM) and QOL assessment in rehabilitation clinical practice.DESIGN: Case analysis.SETTING: Zhongshan Hospital of Fudan University.PARTICIPANTS: Totally 83 rehabilitation patients selected from Shanghai Zhongshan Hospital from January to December 2003,consenting to take part in the study, were divided into 4 groups: bone & joint rehabilitation(n=42), stroke rehabilitation (n=17), internal medicine (n=15), and cancer rehabilitation (n=9).METHODS: Every patient carried out functional independence assessment and quality of life measurement within 24 hours of admission. FIM was adopted for functional independence assessment which included 13 items of motor (ranged from 13 to 91 points) and 5 items of cognition (ranged from 5to 35 points), and FAQ for quality of life included making telephone call,self-care economy, shopping, using vehicle, housework, jobs, entertainment,etc. with 100 in total. The author performed all the assessment.MAIN OUTCOME MEASURES: Every patient carried out FIM and FAQ assessment after admission and discharge.RESULTS: All data of totally 83 patients entered the final analysis. [1]The average age and length of hospital stay in stroke group were higher than those in other groups (P ＜ 0.01). [2] FIM motor and cognitive scores in stroke group were higher at discharge than those at admission (5.276,3.624;6.200,5.941,P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (1.253, 1.547, P ＜ 0.01). [3]In bone joint group, the FIM cognitive scores were coincidence in general, while motor scores were higher at discharge than those at admission (6.220,5.388, P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (0.610, 0.912, P ＜ 0.01). [4] Only scores of functional activity in tumor group were lower at discharge than those at admission (0.722, 0.989, P ＜ 0.05). [5] All items in internal medicine group were coincidence in general (P ＞ 0.05).CONCLUSION: FAQ is more sensitive than FIM in rehabilitation practice, but cannot replace FIM, and should be used with FIM.

Objective To understand the distribution and antimicrobial resistance of pathogenic bacteria isolated from patients in the department of infectious diseases in Xiangya Hospital.Methods The distribution and antimicrobial susceptibility testing results of pathogenic bacteria isolated from patients in this department in 2011 -2015 were analyzed retrospectively.Results A total of 560 strains were isolated during 5 years,of which gram-posi-tive bacteria and gram-negative bacteria accounted for 44.1 % (n =247)and 55.9%(n =313)respectively.69.8%(81/116)of coagulase-negative staphylococcus and 24.3%(9/37)of Staphylococcus aureus were methicillin-resistant (MRCNS,MRSA)respectively.Enterococcus was highly susceptible to vancomycin,linezolid,and phosphonomy-cin (>81 %).Enterobacteriaceae remained highly susceptible to carbapenems (88.9%-100.0%),and was suscep-tible to amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam (>84%).Acinetobacter baumannii was the major isolated multidrug-resistant organism (MDRO),isolation rate of imipenem-resistant Acinetobacter baumannii increased from 50.0% in 2011 to 77.8% in 2015,its resistance rate to imipenem was 64.9%.Conclusion The majority of clinically isolated pathogenic bacteria from this department is gram-negative bacilli,and detection rate of MDROs showed an upward trend;antimicrobial agents should be chosen according to distribution and antimicrobial resistance of pathogenic bacteria.

ObjectiveTo compare the clinical effects of extracorporeal shock wave lithotripsy (ESWL) and ureteroscope holmium laser lithotripey(URL) in emergency patients with ureteral calculi.MethodsTwo hundred and forty emergency patients with ureteral calculi were retrospectively analyzed,including 110 patients undergoing ESWL (ESWL group) and 130 patients undergoing URL (URL group).Results The success rate of fragmentation and calculi-free rate were 90.0％ (117/130) and 80.8％(105/130) in URL group,of which were 88.2％(97/110) and 75.5％(83/110) in ESWL group with no significant difference between two groups (P ＞ 0.05 ).The success rate of fragmentation and calculi-free rate of upper ureter in ESWL group were much better than those in URL group[93.1％(54/58) vs.84.3％(59/70),77.6％ (45/58) vs.70.0％ (49/70),P ＜ 0.05 ],those of middle-lower ureter in URL group were much better than those in ESWL group[96.7％(58/60) vs.82.7％(43/52),93.3％(56/60) vs.73.1％(38/52),P＜0.05].ConclusionESWL and URL both have good curative effects in emergency patients with ureteral calculi,and ESWL has better effects for upper ureter while URL for middle-lower ureter.

Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy(PCNL) by middle renal calice used as main access for the treatment of staghorn stones with the combination of pneumatic and ultrasonic lithotrite.Methods Clinical data of 73 patients underwent PCNL by middle renal calices as main access with 57 incomplete staghorn stones and 35 complete staghorn stones.The rate of stone removal and complications were the main points of the analysis.Results Seventy-two cases underwent first session PCNL by single access tract(middle calices),3 cases underwent first session PCNL by double access tracts (2 cases by middle and lower calices,1 case by upper and middle calices).Of these patients,1 case had fragments with no further treatment,16 cases underwent second session PCNL.All were treated by single access tract (middle calices) and 2 cases had extracorporeal shock wave lithotripsy before the second PCNL.Seventy-six cases composed of 27 complete staghorn stones and 49 incomplete staghorn stones had no residual fragments with the stones removal rate 82.6％ (76/92).Hemoglobin dropped 1-4 g/L,11 cases and 3 cases were given blood transfusion in the operation procedure and post operation respectively.One case developed pyelonephritis and 1 case had split renal dysfunction with peri-parenchyma infection.Conclusions By middle calices as a main access to perform PCNL for staghorn stones is effective and safe.Using pneumatic and ultrasonic lithotrite will be very useful with high stones free rate and short procedure time and less complication.

Objective To detect the protective role of high mobility group box-1 protein (HMGB1 )antibody in concanavalin A(ConA)-induced liver injury in mice.Methods The healthy male Balb/c mice were grouped into con-trol group (saline injection),model group(ConA injection)and experimental group(ConA+HMGB1 antibody injec-tion).After 6 hours of injection,mice blood was collected for detecting alanine transaminase (ALT)and HMGB1 , liver tissue was used to do HE stain,Tunel,and immunofluorescence detection.Results Pathological inflammation in experimental group was slighter than model group.The levels of ALT and HMGB1 in mice serum were (52.00± 8.34)U/L and (7.54 ±0.53)ng/mL in control group,(5 551 .50 ±1 445.74)U/L and (18.06 ±1 .65 )ng/mL in model group,(1 977.40±654.89)U/L and (10.77±0.71)ng/mL in experimental group,respectively;the expres-sion levels of HMGB1 mRNA and HMGB1 (relative value)in liver tissue were 1 .886±0.253 and 0.086±0.028 in control group,4.718±0.341 and 0.268±0.043 in model group,3.005 ±0.331 and 0.116±0.008 in experimental group,respectively;the expression levels of ALT and HMGB1 in serum,as well as HMGB1 mRNA and HMGB1 in liver tissue of experimental group were all lower than model group(all P <0.001).Apoptosis and HMGB1 migra-tion in the liver cell (normalized)were 1 ±0 and 1 ±0 in control group,4.67 ±0.33 and 4.50 ±0.22 in model group,2.67±0.21 and 2.33 ±0.21 in experimental group,respectively;apoptosis and HMGB1 migration in liver tissue of experimental group were both lower than model group(both P <0.001).Conclusion HMGB1 antibody can improve the pathological injury of liver tissue,and protect mice liver against the injury induced by ConA.

The aim of this study was to investigate the effect of Paris saponin I (PS I) on human gastric carcinoma cell growth and apoptosis and to explore the potential mechanisms. The proliferation of SGC7901 cells was monitored by the MTT cell viability assay, while the nuclear morphology of apoptotic cells was assessed by Hoechst 33258 staining. Flow cytometry was performed to analyze the cell cycle progression of propidium iodide (PI)-stained SGC7901 cells and the apoptotic rate of annexin V/PI-stained cells. Western blotting was used to examine the expression of several cell cycle proteins, including cyclin B1 and Cdk1, and the apoptosis-regulated proteins Bcl-2, Bax, cytochrome c, procaspase-9, and procaspase-3. The MTT assay demonstrated that PS I could induce significant dose- and time-dependent inhibition of SGC7901 cell proliferation. Marked morphological changes, including condensation of chromatin, nuclear fragmentation and apoptotic bodies were clearly shown on Hoechst 33258 staining. PSI treatment also resulted in the disruption of the cell cycle at G(2)/M and the induction of apoptosis. Following PSI treatment, the cell cycle-related proteins cyclin B1 and Cdk1 were down-regulated. Expression of the pro-apoptotic protein Bax was increased, while anti-apoptotic protein Bcl-2 decreased. PSI treatment resulted in elevated cytoplasmic cytochrome c and activation of the apoptotic proteases caspase-9 and caspase-3. These data indicate that PS acts as an inhibitor of proli I feration in SGC7901 cells by inducing cell cycle arrest and mitochondria-dependent apoptosis. PSI is a potential therapeutic agent against human gastric carcinoma.

Hepatitis C virus genotype 3 (HCV G3) infection is the second most prevalent hepatitis C genotype globally, with higher rates of disease progression and mortality compared with other genotypes. After the advent of direct-acting antiviral drugs (DAAs), the efficacy of antiviral therapy for hepatitis C patients has been greatly improved, but the therapy for G3 type is less effective than that for other genotypes, so it is considered to be one of the most difficult subtypes to treat. This article reviews the available treatment options for HCV G3 patients and their sustained virological response rates to provide clinical reference.

The aim of this study was to investigate the effect of Paris saponin Ⅰ (PS Ⅰ ) on human gastric carcinoma cell growth and apoptosis and to explore the potential mechanisms.The proliferation of SGC7901 cells was monitored by the MTT cell viability assay,while the nuclear morphology of apoptotic cells was assessed by Hoechst 33258 staining.Flow cytometry was performed to analyze the cell cycle progression of propidium iodide (PI)-stained SGC7901 cells and the apoptotic rate of annexin V/PI-stained cells.Western blotting was used to examine the expression of several cell cycle proteins,including cyclin B1 and Cdkl,and the apoptosis-regulated proteins Bcl-2,Bax,cytochrome c,procaspase-9,and procaspase-3.The MTT assay demonstrated that PSⅠ could induce significant doseand time-dependent inhibition of SGC7901 cell proliferation.Marked morphological changes,including condensation of chromatin,nuclear fragmentation and apoptotic bodies were clearly shown on Hoechst 33258 staining.PSⅠ treatment also resulted in the disruption of the cell cycle at G2/M and the induction of apoptosis.Following PSⅠ treatment,the cell cycle-related proteins cyclin B 1 and Cdk1 were downregulated.Expression of the pro-apoptotic protein Bax was increased,while anti-apoptotic protein Bcl-2decreased.PSⅠ treatment resulted in elevated cytoplasmic cytochrome c and activation of the apoptotic proteases caspase-9 and caspase-3.These data indicate that PSⅠ acts as an inhibitor of proliferation in SGC7901 cells by inducing cell cycle arrest and mitochondria-dependent apoptosis.PSⅠ is a potential therapeutic agent against human gastric carcinoma.

Objective To analyze the relevant factors affecting prognosis of pulmonary infection after renal transplantation.Methods The clinical data of 40 patients who suffered from pulmonary infection after renal transplantation at the First Affiliated Hospital of Jinan University from January 2000 to December 2010 were analyzed retrospectively.By Cox risk model,single and multi-analysis were performed on 20 possible factors,including age,gender,time of infection,type of infection,white blood cell count,neutrophil ratio, hemoglobin,blood glucose,serum creatinine (Scr),pulmonary infection complicated with acute respiratory distress syndrome or acute pulmonary injury,rejection,blood transfusion,infusion of albumin,infusion of immune globulin,use of ventilator,way of offering oxygen,immunosuppressive regimen,dosage change of immunosuppressant,anti-infection therapeutic regimen and length of stay.Results and Conclusions Triple immunosuppressive therapy without mycophenolate mofetil (MMF ) and increase of neutrophil ratio were independent risk factors for pulmonary infection after renal transplantation.Triple immunosuppressive therapy with MMF combined with early anti-infection therapeutic regimen may improve patient and graft survival of patients with pulmonary infection after renal transplantation.

Objective:To explore the influencing factors of early postoperative complications after radical resection of congenital choledochal cyst (CCC) in a single center and provide some clinical basis and guidance for reducing postoperative complications.Methods:Case control study.Clinical data of 124 children (29 boys and 95 girls) with CCC diagnosed and radically treated at the Affiliated Hospital of Zunyi Medical University from September 2010 to October 2019 were analyzed.According to postoperative complications (bile leakage, gastrointestinal anastomotic fistula, bleeding, incision dehiscence, cholangitis, abdominal infection, pancreatitis, and lymphatic fistula), these children were divided into the complication group (group A) and non-complication group (group B). Age, laboratory indicators[preoperative white blood cell (WBC) count, hemoglobin, glutamic pyruvic transaminase, prealbumin, and postoperative albumin], and clinical factors, such as operation method, operation time, intraoperative blood loss, cyst type, cyst diameter, hepatic duct diameter, abdominal operation history, biliary sludge and calculus, hepatic duct anatomic variation, and pancreaticobiliary maljunction were statistically analyzed between the two groups.The t-test was performed for normal distribution of the measurement data, and the non-parametric rank sum test for non-normal distribution.Multivariate analysis was made using Logistic regression. Results:Among the 124 children, 25(20.16%) had complications, and 99(79.84%) had no complications.Bile leakage occurred in 14 children (11.29%), of whom 7 received operation again and 7 received conservative treatment.Gastrointestinal anastomotic fistula occurred in 2 children (1.61%), of whom 1 was re-operated and 1 was cured conservatively.One child (0.81%) was complicated with bleeding and cured by re-operation.Two children (1.61%) were complicated with incision dehiscence, of whom 1 was cured by re-operation and 1 was cured by conservative treatment.Cholangitis in 2 children (1.61%), abdominal infection in 2 children (1.61%), pancreatitis in 1 child (0.81%), and lymphatic fistula in 1 child (0.81%) were all conservatively cured.No significant difference was found in non-normal distribution indicators-age and WBC count-between the two groups (all P>0.05). Blood loss volume and cyst diameter were significantly different between the two groups (all P<0.05). Postoperative albumin[(27.84±4.62) g/L vs.(32.45±3.72) g/L] meeting the normal distribution showed a statistically significant difference between the two groups ( t=5.254, P<0.05). Logistic multivariate regression analysis suggested that preoperative anemia ( OR=7.922, 95% CI: 1.468-42.757) and biliary sludge and calculus ( OR=1.295, 95% CI: 1.075-4.359) were independent risk factors for postoperative complications; postoperative albumin ( OR=0.055, 95% CI: 0.012-0.244) was a protective factor for postoperative complications, and the differences were statistically significant (all P<0.05). Conclusions:The larger the cyst diameter, the more the intraoperative bleeding, and the higher the risk of operation.Treating anemia before operation, clearing sludge in the hepatic duct during operation, reducing bleeding, and strengthening the monitoring of albumin and hemoglobin during the perioperative period can prevent and reduce early complications after radical resection of CCC in children.