OBJECTIVE To analyze predisposing factors and investigate the measures to fungemia.METHODS The clinical features,therapy and outcome of 17 patients with fungemia which happened from 1995 to 2004 were(retrospectively) reviewed.RESULTS The morbidity of fungemia was 5.52% in all septicemia in our hospital.Candida(tropicalis) and C.albicans were the major fungal species.There were 6 patients found cultured fungi on local(foci).Tracheotomy and mechanical ventilation (47.06%),indwelling urinary catheter(41.18%),indwelling(central) venous catheter and drainage tube(41.18%),persisted use of broad spectrum antibiotic(76.47%),(chemical) therapy(17.65%),admission to ICU(29.41%),and neutropenia(29.41%) might be the predisposing(factors).The mortality of fungemia was 70.59%.CONCLUSIONS The morbidity of non-C.albicans fungemia is(increasing),preemptic therapy should be begun earlier.Higher dose of fluconazole may be recommended in clinical usage.

Objective To explore the expressions of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 in breast cancer and their relationship with clinicopathology.Methods The expressions of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 proteins were detected in 80 cases of patients with breast cancer using immunohistochemical Streptavidin-Perosidase(SP) method,and were analyzed with clinical and medical records.Results The positive expression rates of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 in breast cancer were 60.0％,57.5％,45.0％,80.0％,48.8％ and 82.5％,respectively.In addition to C-erbB-2 which had correlation with lymph node metastasis,other five indicators showed no significant correlations with patient age,lymph node metastasis,tumor size and pathological grade.Conclusion There is a certain correlation in the expressions of ER,PR,C-erbB-2,E-Cad,p53 and Ki-67 in breast cancer.Combined detection is valuable in the treatment and prognostic evaluation of breast cancer.

Objective: To study the relationship between immune function and psychosocial factors of patients with malignant tumors Method:37 inpatients with malignant tumors were collected They had no chemotherapy or radiotherapy in the past month and without history of immune disease or medication influencing immune system 37 inpatients of internal department without tumor were collected as control All subjects completed EPQ, SCL-90, SAS, SDS, LES, SSRS and DSQ Researchers assessed their mood with HAMA and HAMD, and their immune function by measuring serum IgG, IgA, IgM, C 3, C 4, CH50 and sub-groups of lymphocyte Results:Study group had lower IgM and less CD 16 + than control The level of IgM was associated with course of disease, educational level, gender, personality, defense style, negative life events and social support The level of CD 3 + was associated with depression in addition to other factors mentioned above Conclusion: Patients with malignant tumors have immune dysfunction, which associated with psychosocial factors such as negative life events, social support and depression

To understand the continuing medical education status of Beijing Shijitan Hospital,so as to continue to reform and improve the teaching management of continuing medical education.,literature and information retrieval methods were used and relevant personnel was interviewed about the content,form,time and suggestions of continuing medical education.The results indicate the presence of training content is too wide,training methods are too simple,and there is lack of medical humanities quality training and other issues in continuing medical education.Variety of training methods should be increased,the quality of medical humanities education and training should be enhanced,featured training should be developed to make the continuing medical education more scientific,standardized and highly efficient.

Objective To observe the impact of different surgical procedures on ovarian reserve and analge-sic effects of drug use in patients with uterine fibroids.Methods 100 patients with uterine fibroids were randomly divided into two groups.50 patients in control group were implemented traditional open surgery.50 cases in the obser-vation group received laparoscopic myomectomy.The ovarian reserve changes were compared before and after surgery, pain medication use and changes in the degree of pain conditions.Results The levels of follicle stimulating hormone and luteinizing in the control group one,three months after operation were significantly higher than before surgery and the observation group,the level of estrogen was significantly lower than before surgery and observation group,the differences were statistically significant(t=10.23,14.58,9.78,11.76,9.83,9.92,10.07,11.23,all P<0.05).The postoperative first pain time of the observation group was significantly longer than the control group,the difference was statistically significant[(513.74 ±284.52)min vs.(61.38 ±37.21)min,t=92.34,P<0.05].The postoperative analgesic usage of the observation group was significantly lower than the control group,the difference was statistically significant(14.0% vs.58.0%,χ2 =7.83,P<0.05).The pain scores 3d,4d,5d,6d and 7d after operation of the observation group were significantly lower than the control group(t=2.11,2.30,2.58,7.03,6.46,all P<0.05). Conclusion The patients with uterine fibroids laparoscopic myomectomy for treatment will not cause great impact on the patients'ovarian reserve,and can effectively reduce the use of analgesics,and it is worthy of further promotion.

Hypofractionated three-dimensional confornul radiotherapy (3DCRT) makes it possible to further improve loeal control,overall survival and the quality of life for the patients with non-small-cell lung cancer (NSCLC).But the dose-fractionation and total dose are not yet clear,which need further study.Hypofractionated stereotactic body radiotherapy (SBRT) for early-stage NSCLC patients is well tolerated and results in excellent local control and overall survival.SBRT is expected to become a new standard treatment in patients with early stage NSCLC.

AIM:To investigate the effect of NF-κB binding element deletion on transcriptional regulation of (NOX1).METHODS:pGL3-Basic vector inserted with the NOX1 proximal promoter, and the same vector inserted with the NOX1 proximal promoter in the absence of the positive NF-κB binding element, were constructed.After cloning, diges-tion and purification, NOX1 proximal promoter (≈1 415 bp) was inserted into the multicloning site of the pGL3-Basic vec-tor and then sequenced ( pGL3-NOX1-1415) .NF-κB binding elements in the NOX1 promoters were predicted by Alibaba 2.1 software.The positive element was deleted by overlapping PCR.The deletion mutant was inserted into the pGL3 vector in the same way (pGL3-NOX1-1327).The plasmids were transfected into A549 cells, and then the cells were stimulated with TNF-α.The luciferase activity was monitored on MD SpectraMax M5 enzyme-labeled instrument.RESULTS:The se-quences of pGL3-NOX1-1415 and pGL3-NOX1-1327 were identified to be correct.Compared with control group, the lucif-erase activity was significantly higher in the cells transfected with pGL3-NOX1-1327 (P<0.05), but it was significantly lower than that in the cells transfected with pGL3-NOX1-1415 (P<0.05).CONCLUSION: NF-κB plays an essential role in the transcriptional regulation of NOX1 in TNF-α-induced A549 cells.Activated NF-κB binds to specific elements in NOX1 promoter regions to control the transcription.

Purpose To investigate the clinical effect of ultrasound guided drainage combined with different hardeners for simple breast cysts,and to further provide reference for individual treatment.Materials and Methods Clinical data of 117 cases breast simple cysts were analyzed retrospectively,of which 42 cases were routine ultrasound-guided puncture combined with fluid injection of hypertonic sugar (group A),40 cases were routine ultrasound guided drainage combined with ethanol injection therapy (group B),and 35 cases were routine ultrasound guided therapy alone (control group).The clinical efficacy and adverse reactions were compared among the three groups after treatment.Results The total effective rate of group A was 95.24％,group B was 97.50％,and control group was 82.86％.Total effective rate of group A and B had no significant difference (P＞0.05),which were both higher than control group (P＜0.05).The adverse reactions rate of group B was higher than group A and control group,which had statistical significance (P＜0.05).Conclusion Ultrasound guided injection of hypertonic sugar or ethanol after drainage treatment for simple breast cysts can both obtain satisfactory clinical results,but adverse reactions of the former one are mild,it should be widely applied.

AIM:To determine the content of the trace arsenic and mercury in Fructus Mume and Fructus Mume charcoal. METHODS:Atomic fluorescence spectrometry was used. RESULTS:The content of arsenic in Fructus Mume is 0.0597～1.0001 mg?g -1, that of mercury is 0.0198～0.0300 mg?g -1. CONCLUSION:This method is simple to handle, the quantitative analysis is accurate.

From January 2014 to June 2014,a total of 178 primiparas and biparas scheduled for a 42-day postpartum follow-up visit at our hospital were examined.And their pelvic floor dysfunctions were evaluated according to the surveys of incontinence impact questionnaire,short form (IIQ-7),pelvic floor impact questionnaire-7 (PFIQ-7) and pelvic organ prolapse/urinary incontinence sexual questionnaire (PlSQ.12).And 130 primiparas and 48 biparas lacked an understanding of performance,prevention and treatment for postpartum pelvic floor dysfunction.And two groups showed no significant difference.The selfdiscovery and detection rates of decreased pelvic myodynamic were 9.2％ and 14.6％ in primiparas versus 10.4％ and 16.7％ in biparas.The self-discovery and detection rates of pelvic organ prolapse were 0.8％ and 2.3％ in primiparas versus 0.0％ and 8.3％ in biparas.And the difference was statistically significant.Most related knowledge came from parents and colleagues in 53.1％ (95/178) and doctors and nurses in 15.5％ (27/178).Only about 44.4％ (12/27) women with prominent symptoms of pelvic floor dysfunction requested treatments.Therefore the related knowledge of postpartum pelvic floor dysfunction should be strengthened.