Background and purpose:Venous thromboembolism (VTE) is the second common cause of death in cancer patients. The clinical data from VTE patients in Fudan University Shanghai Cancer Center were collected and analyzed during the last 5 years in this study to increase awareness for diagnosis and prevention of VTE in cancer patients and to improve their prognosis.Methods:The clinical data from 196 VTE patients among the 207 514 cancer patients were analyzed during the period from Jul. 2009 to Jun. 2014, and the clinical characteristics of cancer patients with VTE were investigated to understand the inlfuence of risk factors and symptoms in VTE patients.Results:The incidence of VTE in cancer patients was 0.94‰. Adenocarcinoma was the most common type of gynecological cancer (56.5%), gastrointestinal tract cancer (91.7%), lung cancer (71.4) and pancreatic cancer (80%). Logistic regression analysis showed adenocarcinoma was the high risk factor in cancer patients with pulmonary embolism (PE, OR=0.36, 95%CI: 0.146-0.885,P=0.026). Compared with patients who received 2 cycles of chemotherapy, patients who received 3 cycles of chemotherapy had higher incidence of VTE (χ2=10.976,P=0.001). The incidence of VTE in operative group was higher than that in non-operative group. The patients bearing gynecological cancer with ascites (>2 000 mL) had higher VTE incidence compared with the patients with less ascites. Besides, 78%-88% of the VTE patients were diagnosed because of the deep vein thrombosis (DVT) symptom during postoperative recovery and chemoradiotherapy.However, 59.1% of the preoperative VTE patients were diagnosed by the compression venous ultrasonography (CUS) in lower extremity. Physical therapy was adopted to prevent thrombus in 15 postoperative patients.Conclusion:The incidence of cancer-associated VTE in Fudan University Shanghai Cancer Center is lower compared with those reported in other epidemiologic investigations. The VTE incidence in postoperative patients is higher than that in preoperative patients. The patients with adenocarcinoma were inclined to be accompanied by PE. The examination should be taken in asymptomatic cancer patients and gynecological cancer patients with massive ascites. The physical measurement should be adopted actively to prevent thrombus in our hospital.

The paper introduces American health informatization talents cultivation scheme, combining the current situation and ex-isting problems of medical information management talents cultivation in China, it proposes medical information management undergradu-ate talents cultivation strategies under the strategic background of population health informatization from three perspectives: curriculum system, teaching staff and teaching mode.

Objective To identify the cell death type and investigate the potential mechanism of ionizing radiation-induced neural cell death in the neonatal rat cerebral cortex.Methods The neonatal Wistar rats were given a single dose of 2.0 Gy γ-irradiation.The cell death type and characterization in cerebral cortex were identified using DNA electrophoresis,TUNEL and HE staining.The P53-and iNOS-positive cells were analyzed quantitatively using immunohistochemistry.Results The DNA and morphological characterization of death cells indicated that 2.0 Gy γ-irradiation induced apoptosis of the neural cells in neonatal rat cerebral cortex.The apoptosis indices in different cortex regions were significantly increased 4 h after irradiation,and reached the peak value at 12 h post-irradiation.The apoptosis index of neoconex was much higher than that of hippocampus(archicortex)and paleocortex,while paleocortex had lower apoptosis index than hippocampus.The quantitative immunohistoehemistry suggested that the numbers of P53 and iNOS-positive cells were not different between these three cortex regions at the same time-point after irradiation.Conclusion 2.0 Gy γ-rays induced apoptosis of the neural cells in neonatal rat cerebral codex.The response of cells to the damage effects of ionizing radiation was similar in different cortex regions;however,the apoptosis indices were different significantly.These findings imply that the developing phase or type of neural cells may play a pivotal role in the apoptosis process induced by ionizing radiation.

Objective To observe the influence of endoscopic harvesting technique on the prevalence of leg-wound complications after coronary artery bypass grafting, and to assess histologically the potential trauma to the vein. Methods From August,2003 to August, 2005, 256 patients undergoing CABG had saphenous vein harvested by endoscopic harvesting system. About 4 mm proximal and distal vein end segment of 10 patient undergoing endosocopic and conventional harvesting respectively were examined with light and electro-microscope. Results The mean number of vein grafts of ESVH was 2.2 and the mean endoscopic harvest time was (45?20) minutes. There was no complication (incision infection, edema of lower extremity, lymphangitis and fat necrosis) occurred. Stay in bed time was 2～3 days. There was no difference in result of light and electro-microscopy. Conclusion Endoscopic vein harvesting in coronary artery bypass grafting can decreases the prevalence of postoperative leg-wound infections, postoperative pain, lying time and hospital stay, and increase the postoperative mobility ability, especially in patient with obesity and diabetes mellitus. Furthermore, the endoscopic harvesting technique may do no additional trauma to the saphenous vein.

Objective To determine the effectiveness of ETCD ( endoscopic transpapillary cyst drainage) in treatmen! of pancreatic pseudocysts. Methods Twenty-six patients with pancreatic pesudocysts were selected. They are presented some indications for treatment and the pesudocyst were ranged in size from 1.5 to 15 cm. Of 23 cases 38 sessions of ETCD were performed. In two of thirty-eight cases the cyst bulges were invisible in the stomach or duodenum due to its compression. In one case ETCD was employed after percutaneous drainage of the pseudocyst, the other one was treated after combination therapy of plastic stent ing because of jaundice. Results Improvement of abdominal pain, changes in appetite, body weight and fat in stool were recorded in follow-ups of 60 ~ 850 days. There was only one asymptomatic recurrence. One case was complicated with pancreatic abscess. There was no mortality related to the procedure. Surgical intervention became necessary in three cases because of inadequate drainage or complication. Conclusion ETCD treatment of symptomatic pancreatic pseudocysts with ductal communication, the transpapillary pancreatic duct stenting is a safe, effective modality and should be considered as the first line therapy; on the other hand for those pancreatic pseudocyst without communication to the main pancreatic duct it is not effective.

Diphenylamine ; Humans ; Poisoning/diagnosis* ; Tablets

Background and purpose:Previous researches have shown that procalcitonin differentiates infec-tious from non-infectious fever and assesses the severity of infectious diseases. This study aimed to investigate the clin-ical value of procalcitonin in patients with chemotherapy-induced febrile neutropenia.Methods:A total of 147 patients with chemotherapy-induced febrile neutropenia admitted to intensive care unit from Jan. 2012 to Dec. 2014 were di-vided into infectious group and fever of unknown origin group according to clinical symptoms, signs and etiology. The infectious group was divided into sepsis, severe sepsis, and septic shock groups according to the severity of infection. The procalcitonin levels were compared between different groups.Results:A procalcitonin cut-off value>0.935 ng/mL provided a sensitivity of 90.0%, speciifcity of 90.0% and AUC=0.905. The procalcitonin level of the infectious group was signiifcantly higher than that of the fever of unknown origin group [1.805 (1.268-2.523) ng/mLvs 0.555 (0.398-0.818) ng/mL,P<0.001]. There is a signiifcant difference between the severe sepsis group and the sepsis group [13.885 (7.600-17.961) ng/mLvs 1.805 (1.268-2.563) ng/mL,P<0.001]. Compared with the severe sepsis group, the value of procalcitonin in the septic shock group was signiifcantly higher [23.800 (20.050-30.478) ng/mLvs 13.885 (4.955-19.133) ng/mL,P<0.001].Conclusion:Plasma procalcitonin is a useful marker for diagnosing neutropenia in patients with infection. Meanwhile, procalcitonin can be used to assess the severity of infection in patients with neutropenia.

Objective To establish the platelet antigen panel for identifying the specificity of platelet antibodies which cause platelet transfusion refractoriness and neonatal alloimmune thrombocytopenia and provide evidence for clinical therapy and platelet genotyping research.Methods Based on the frequency distribution of human platelet alloantigen (HPA)-1 to HPA-16 gene in China, the frequencies of HPA-1 to HPA-6,HPA-15 alleles in blood group O donors were genotyped by the polymerase chain reaction with sequence-specific primers (PCR-SSP) method, and suitable donors were chosen to establish platelet-specific antigen panel.Using the established platelet-specific antigen panel, the specificity of platelet antibodies caused by alloimmune reaction was identified by using simplified sensitized erythrocyte platelet serology assay (SEPSA).Results Eleven ptatelet donors with blood group O were chosen to establish platelet-specific antigen panel which can identify specificity of HPA-1 to HPA-6, HPA-15 antibodies.One case of HPA-4b (Penb) and two cases of HPA-15a (Govb) platelet specific antibodies were detected in 1 120 samples.Conclusion Identifying the specific platelet antibodies using platelet specific antigen panel has profound significance on increasing the safety and effectiveness of clinical platelet transfusion and prevention of neonatal alloimmune thrombocytopenia.

Objective To evaluate the diagnostic performances of seven estimation formulas for glomerular filtration rate (GFR) in pre-operative patients with renal cell carcinoma.Methods A total of 386 pre-operative patients with renal cell carcinoma in the first affiliated hospital of Chongqing medical university from January 2012 to October 2014 were selected.All the patients' GFRs were measured by the renal dynamic imagingwith 99mTc-DTPA as reference (rGFR) and the seven GFR estimation equations (eGFR) were compared with the rGFR respectively.Their correlations and consistencies were observed with spearman correlation analysis and Bland and Altman analysis.The diagnostic sensitivity,specificity and likelihood ratios were calculated and the eGFR accuracies were assessed with receiver operator curve (ROC) analysis.Results The correlations between the rGFR and eGFRs were significantly (P＜0.001).In addition,CKD-EPI-Asian Crea and Ruijin formula were more accurate than others in different stages with larger ROC area in diagnosing renal cell carcinoma.Conclusion There were significant correlations between the eGFRs and rGFR,but some deviations existed.CKD-EPI-Asian Crea and Ruijin formula were more suitable for assessment of eGFR of pre-operative patients with renal cell carcinoma.However,both of these equations had a few limitations.

Objective To observe the structural characteristic of Marshall ligament and coronary sinus of 40 dog hearts. Methods The Marshall ligament and coronary sinus of 40 dog hearts fixed with 10% formaldehyde were observed in gross anatomy. Results The Marshall ligament begins at the right external side edge of left atrium appendage, via the left inferior pulmonary vein to the inner surface of pericardium. The length and the width of Marshall ligament of dog hearts were (2.61?0.95) cm, (0.18?0.04) cm respectively. The angle between Marshall ligament and the coronary sinus was (116?11), and the shortest length between Marshall ligament and left atrium was (0.58?0.52) cm. The length and the width of coronary sinus was (2.84?0.85) cm, (0.28?0.07) cm respectively. There are lots of cardiac fibers of ring (47.5%), vertical (37.5%) and diagonal (15%) shape on the surface of coronary sinus. Conclusion A lot of muscle fibers attaching to the surface of Marshall ligament and coronary sinus in dog hearts are abnormal atrial channels. Dog is the favorable animal for research of focal atrial fibrillation.