Objective To explore the change and clinical significance of serum Cystain-C in children with Henoch-Schonlein purpura(HSP).Methods Thirty-three children diagnosed HSP according to the domestic criteria hospitalized in department of pediatrics were enrolled in patient group and 31 children outpatients during the corresponding time period as controls.Venous blood of each child in 2 groups was collected in the day of admission,serum Cystain-C was determined by enzyme-linked immunosorbent assay,plasma D-dimer was measured by gold standard double antibody sandwich method,and blood urea nitrogen(BUN) and serum creatinine(Scr) were detected by automatic biochemistry analyzer.At the same time each child undertook routine urine examination.Data was analyzed by Stata 8.0 software.Results 1.BUN and Scr of 2 groups were both normal.2.Proteinuria or hematuria was found in 15 of all 33 patients through routine urianlysis,and the detection rate was 45%.3.The pre-and post-therapy level of serum cystain-C[(3.83?0.83) mg/L,(3.76?1.02) mg/L] and plasma D-dimer [(1.93?2.05) mg/L,(0.77?0.79) mg/L] in HSP group were higher than that in controls [(1.21?0.43) mg/L,(0.13?0.07) mg/L] significantly (P0.05).5.In HSP group,the level of plasma D-dimer pretherapy was significantly higher than that of post-therapy(P0.05).Conclusion The level of serum Cystain-C can act as the significant indicator of early diagnosis and continuous observation of HSP nephritis.

Objective To investigate the effect of social support and childbirth self-efficacy-enhancing intervention on primiparas' childbirth self-efficacy,coping ability and pain during labor.Methods A randomized controlled trial was used with double blindness design.One hundredand six primiparas were recruited as the intervention group and control group,53 cases in each group.The two groups adopted the routine prenatal care.In addition,the intervention group participated in twice childbirth self-efficacy-enhancing educational courses.The Chinese Childbirth Self-Efficacy Inventory (CBSEI) was used to conduct the comparison between before and after intervention;the interventional effects in the natural childbirth pregnant women were compared between the two groups by adopting the Visual Analogue Scale (VAS) and Childbirth Coping Behavior Scale (CCB);the Multidimensional Scale of Perceived Social Support (MSPSS) was adopted to analyze correlation between the social support level with the CBSEI and CCB.Results The intervention group finally had 52 cases of effective sample and the control group had 51 cases of effective sample.The CBSEI score after intervention in the intervention group was 282.04± 27.38,which was higher than 236.69± 45.39 before intervention.The CCB score in the intervention group was 56.78 ± 6.95,which was significantly higher than 48.03 ± 6.26 in thecontrol group,and the VAS score in the intervention group was 6.96 ± 1.39,which was lower than 8.35 ± 1.43 in the control group,the difference was statistically significant(P＜0.01).The MSPSS score in the two groups was positively correlated with the OE score,efficacy expectancy (EE) score and CBSEI score before intervention(r=0.269,0.289,0.317,P＜0.01).Conclusion Launching the childbirth self-efficacy-enhancing educational intervention of the social support system can effectively improve the childbirth self-efficacy and coping ability of primiparas,and reduce the intrapartum pain level.

Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; metabolism ; secondary ; surgery ; Carrier Proteins ; metabolism ; Diagnosis, Differential ; Endometrial Neoplasms ; metabolism ; secondary ; Female ; Glycoproteins ; metabolism ; Humans ; Immunohistochemistry ; Keratin-7 ; metabolism ; Mastectomy, Modified Radical ; Middle Aged ; Ovarian Neoplasms ; metabolism ; secondary

Objective To evaluate the clinical efficacy and safety of integrated traditional Chinese and Western medicine in treating active rheumatoid arthritis (aRA).Methods A prospective randomized controlled study was carried out. Totally 148 aRA patients were divided into the control group and the treatment group, 74 cases in each group. Control group was treated with MTX (methotrexate) and LEF (leflunomide), while the treatment group took traditional Chinese medicine based on syndrome differentiation, on the basis of treatment with MTX and LEF. The therapeutic course for all was 3 months. Efficacy indexes, like clinical symptoms and signs, ESR, TCM syndrome integrals, DAS 28 score, and safety indexes were observed.Results This study finally completed 136 cases, including 69 cases in the treatment group and 67 cases in the control group. In the two groups, significant improvement of clinical signs and symptoms, ESR, DAS28, and TCM syndrome integrals after treatment were shown, with statistical significance (P<0.01). Better effects were obtained in the treatment group in lessening tender joint numbers and swollen joint numbers, DAS28, and TCM syndrome integrals (P<0.01). The total effective rate of the TCM syndrome efficacy was 86.96% (60/69) in the treatment group, and 76.12% (51/67) in the control group, without statistical significance (P>0.05). The significant efficiency of the treatment group was 11.59% (8/69), and the control group was 5.97% (4/67), with statistical significance (P<0.05). Adverse reactions occurred fewer in the treatment group than in the control group (P<0.01).Conclusion Compared with single traditional Chinese medicine, integrated traditional Chinese and Western medicine for treating aRA can better improve DAS28 and TCM syndrome integrals, and reduce the incidence of adverse reactions.

Objective To explore the effect of the midwife-leading labor pain management model on the pregnancy outcomes and pain control satisfaction.Methods The randomized grouping and single blind trial design were performed.One hundred and ten pregnant women were recruited and randomized into the control group (n=55) and intervention group (n=55).The control group received the routine prenatal examination by the outpatientdepartment obstetric doctors and intrapartum nursing care during labor.On this basis the intervention group participated in the labor pain educational course in the midwife clinic,and received the repeated pain assessment and pain management intervention during labor.Results There was no statistical difference in the delivery mode between the two groups(P＞0.05).The cesarean section rate without indication in the intervention group was significantly lower than that in the control group,the difference was statistically significant(x2 =6.798,P＜0.05).The average each item score of the labor pain education and pain control satisfaction in the intervention group was significantly higher than that in the control group,the difference was statistically significant(P＜0.01).Conclusion The midwife-leading labor pain management model can reduce the cesarean section rate without indication,and improves the satisfaction of labor pain education and pain control in pregnant women and parturients.

Objective:To observe the clinical efficacy and toxicities of bendamustine hydrochloride in patients with rituximab-re-fractory indolent B-cell non-Hodgkin's lymphoma (NHL). Methods:A total of 25 patients with rituximab-refractory NHL received bendamustine hydrochloride 120 mg/m2 intravenously on days 1 and 2 of the 21-day cycle. The short-term response, progression free survival, and toxicities were evaluated. Results:The total number of chemotherapy of the 25 patients was 122 cycles, and the median number was 5 cycles. All patients could be evaluated for efficacy. Among the patients, 6 had complete remission, 13 had partial remis-sion, 3 had stable disease, and 3 had progression disease. The overall response rate and clinical benefit rate were 76%and 88%, respec-tively. Until the deadline, 13 patients had progression disease. The median duration of response was 8 months, and the median progres-sion-free survival (PFS) was 9.3 months. Subgroup analysis showed that PFS is significantly related to bone marrow involvement and serum LDH level (P<0.05). The main adverse effects were myelosuppression, gastrointestinal reactions, and infection. Rash was found in 2 patients, and 1 case of gastric cancer was discovered after 5 cycles of treatment. Conclusion:Bendamustine hydrochloride was ef-fective and tolerable in patients with rituximab-refractory indolent B-cell NHL.

Objective To evaluate the efficacy and safety of fludarabine and pirarubicin (FT) regimen in the treatment of refractory or relapsed indolent non-Hodgkin lymphoma (NHL). Methods A total of 40 patients with relapsed or refractory indolent NHL were treated with FT regimen, one cycle for 28 days, total 6 cycles. The data of indolent NHL patients treated with fludarabine, noventrene and dexamethasone (FND) regimen were collected as control. Results 40 patients were given 228 cycles chemotherapy, overall response rate was 62.5 %, median progression-free survival was more than 20 months and 2 years overall survival rate was 70.0 %. The main toxicities was leucopenia (80.0 %), but the incidence of WHO Ⅲ-Ⅳ leucopenia and pneumonia was less than that of in the control group, the rate were 12.5 % vs 29.0 % and 2.5 % vs 23.0 % respectively (P <0.05). Conclusion The efficacy of FT regimen was as good as FND regimen, but the incidence of leucopenia and pneumonia by Ⅲ-Ⅳ was lower in FT group than in FND group. So the FT regimen was an effective and safe second-line salvage regimen for relapsed or refractory indolent non-Hodgkin lymphoma.

AIM:To describe the application of smart phone and supporting set for acquiring fundus images with slitlamp examination and non-contact lens in primary hospital of the rural area.METHODS:The supporting set for smart phone was purchased from taobao and securely connected to the ocular lens of slitlamp microscopy.The fundus photos were imaged with assistance of non-contact slitlamp lens from Volk.RESULTS:High quality images of various retinal diseases could be successfully taken with smart phone and supporting set by slitlamp examination.The fundus images were send to patients with Wechat as medical records or used for telconsultant.CONCLUSION:High resolution smart phones are wildly used nowadays and supporting sets are very accessible;thus high quality of images could be obtained with minimal cost in rural hospitals.The digital fundus images will be beneficial for medical record and rapid diagnosis with telconsultant.

OBJECTIVETo investigate clonal evolution of abnormal Philadelphia chromosome-negative cells (Ph- CE) after imatinib mesylate therapy in patients with Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML).

METHODSBone marrow cells G-banding karyotype was evaluated every 3 months in 100 patients with Ph+ CML after achieving hematologic responses on the course of imatinib therapy. There were 54 patients in chronic phase (CP), 37 in accelerated phase (AP) and 9 in blast phase (BP).

RESULTSAfter a median follow-up of 32 months (ranged 25-34 months), 11 patients, including 5 cases in CP, 5 in AP and 1 in BP, developed transient, interrupted or continuous Ph- CE after 3 - 29 months on imatinib therapy. Ph- CE emerged at the beginning of Ph+ cells decreasing or after Ph+ cells disappearing. The proportion of Ph- CE, was negatively correlated with the proportion of Ph+ cells (P < 0.05). Ph- CE commonly included +8 (45.5%) and +Y (27.3%). Five patients had additional cytogenetic abnormalities besides Ph+ in Ph- CE. Seven of the patients with Ph- CE achieved a major cytogenetic response while 9 of them achieved a complete hematologic response. One patient with Ph- CE in AP progressed to BP 20 months after the initiation of the therapy while the rests remained in hematologic or cytogenetic responses.

CONCLUSIONPh- CE occurred in about 11% of the patients with Ph+ CML who achieved major or minor cytogenetic responses on imatinib therapy. After a median follow-up of more than 2 years, most of the patients with Ph- CE were in a stable status with no disease progression.

Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Benzamides ; Clone Cells ; drug effects ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Imatinib Mesylate ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; genetics ; pathology ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative ; drug therapy ; genetics ; pathology ; Male ; Middle Aged ; Philadelphia Chromosome ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Treatment Outcome