Adolescent ; Adult ; Colic ; chemically induced ; nursing ; Female ; Humans ; Lead Poisoning ; nursing ; Male ; Middle Aged ; Young Adult

Objective To evaluate the clinical features and treatment outcomes of ocular posteriorsegment syphilis.Methods The clinical data of 24 patients with active ocular syphilis wereretrospectively reviewed.The diagnosis was made first in eye clinic,and verified by treponema pallidumparticle agglutination(TPPA)and rapid plasma reagin(RPR).The patients,17 males and 7 females,aged from 30 to 63 years with an average of 47.6 years.The duration of symptoms ranged from 3 days to2 years with an average of 5.8 months(≤1 month,7 cases;1-3 month,5 cases;3-6 months,5 cases;>6 months,7 cases).There were 18 bilateral cases and 6 unilateral cases.The result of humanimmunodeficiency virus(HIV)test was negative for all cases.Twenty-three patients received systemicpenicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy.Beforetreatment,the mean visual acuity was 0.17±0.1 9,the mean titer of RPR was 1:84.The follow-up periodwas half a year.Results The major ocular manifestations included bilateral(16 cases)or unilateral(1case)chorioretinitis,unilateral retinal vasculitis(2 cases),unilateral neuroretinitis(2 cases),andbilateral(2 cases)or unilateral(1 case)optic neuritis.The mean follow-up visual acuity was 0.60±0.29,the mean follow-up titer of RPR was 1:18.8.Some patients had got the diagnosis and prompt treatment atthe early stage of the disease and their visual acuity recoveried very well.Conclusions The majormanifestion of ocular posterior segment syphilis is chorioretinitis.It is important tO consider the possibilityof syphilis when patients have inflammation of posterior segment.Prompt serology examination andpenicillin treatment are the keys to cure ocular syphilis.

An in-depth analysis of the problems found in the hierarchical medical system,found that the research hospitals should focus on the conceptions of Big Times and Big Health,initiative the task to undertake Strong grass-roots,and actively build leading model of hierarchical medical system based on the PDCA cycle.At the same time,taking the practice of the 2nd Affiliated Hospital of Harbin Medical University as an example,we propose the research hospitals should strengthen service capabilities in primary health care institutions from talent,technology,management and other aspects, so as to enhance the patient's willingness to visit the grassroots,and to promote the further deepening of our medical reformation.

Micro-ribonucleic acids (miRNAs) are endogenous single-stranded small non-coding RNAs. miRNAs bind to a com-plementary site in the 3' untranslated region of their target mRNAs through canonical base pairing, which can direct the degradation or translational repression of these transcripts. Thus, miRNAs can effectively silence the protein expression of target genes post-transcrip-tionally. miRNAs may also regulate the expression of oncogenes and tumor suppressor genes and could be involved in almost all known hallmarks of cancinogenesis. In this paper, we discuss the following in detail:(1) biogenesis and main functions of cellular miR-NAs, (2) stability and detectability of exosomal miRNAs in biological fluids;and (3) feasibility of miRNAs as a potential new class of biomarkers derived from urinary exosome in the malignancy of urinary system. Finally, we summarize studies on urinary exosomal miRNAs as potential biomarkers of prostate, bladder, and kidney cancers.

Objective To investigate the clinical effect of Itopride and esomeprazole combining with deanxit in treating functional dyspepsia ( FD) .Methods Sixty-two patients meeting Rome Ⅲcriterion were randomly divided into the therapy groups which were treated with Itopride and esomeprazole combining with deanxit and the control groups which were treated with Itopride and esomeprazole for 4 weeks respectively .Symptom scoring was done before and after the treatment .Results The symptoms were remarkably improved , there was significant difference in the therapeutic effect between the two groups (P<0.05).The total efficiency was more obvious in the therapy group . Conclusion Itopride and esomeprazole combining with deanxit can produce an effect on the treatment of FD .Itopride and esomeprazole combining with deanxit has better clinical effect than Itopride and esomeprazole on the treatment of FD.

Objective To evaluate endovascular aortic repair for retrograde Stanford type A aortic dissection with an entry tear in the descending aorta.Methods From April 2006 to Dec 2012,31 patients with retrograde type A aortic dissection were treated with endovascular technique.22 patients had pleural effusion,14 patients had patent false lumen in the ascending aorta.Emergency operation was performed in 2 patients with acute right renal artery and right common iliac artery ischemia respectively.29 patients received endovascular treatment after 3 weeks conservative treatment.Chimney technique was used in 3 patients.Results All procedures were technically successful without severe complications.Ascending aorta recovered 1-3 months after operation.Pleural effusion subsided 3 days to 3 weeks after endovascular treatment.During follow-up of (31 ± 18) months,no severe complications developed,all the stent-grafts placed by chimney technique were patent.Conclusions Endovascular aortic repair can be used in the treatment of retrograde Stanford type A aortic dissection.Chimney technique can be used to reconstruct supra-aortic branches.

10.3969/j.issn.1007-3969.2013.04.012

Tumor markers for early diagnosis of cancer is an important auxiliary mean,which for early tumor detection,monitoring and for judging curative effect of treatment regimens play important role.Clinical method for early diagnosis on ovarian cancer is the detection of serum CA125,however,its precision and specificity for early diagnosis are not enough.It has been found that in the development period of the patients with ovarian cancer,SMRP and CA125 is co-expression.This article reviews the value of serum mesothelin on diagnosis of epithelial ovarian cancer to provide reference on early diagnosis and treatment.

Objective To explore the application value of ATP bioluminescence in assaying the cleaning quality of uterine suction.Methods According to the principle of random,we selected 120 uterine suction tube after use.60 used tubes in A group were given water immersion + high-pressure water jets wash + dry method,60 used tubes in B group were given alkaline cleaning solution soak + ultrasonic + high-pressure water washing + manual scrub + drying method.The quality of suction tube was initially tested with the visual method after cleaning,Straw inside the top cavity,2.5cm at inside straw joint and the front of straw outer wall,10cm at suction cavity wall,before and after cleaning the residues of bacteria were assayed with the ATP bioluminescence and bacteria counting method for parallel comparison.Results After cleaning drying program,the RLU of two groups in suction head internal top,2.5cm at inside straw joint,the front of straw outer wall,10cm at suction cavity wall had significant differences (t =26.81,29.13,7.14,55.74,P ＜ 0.01).The cleaning effect of B group was better than A group..Bacteria counting method was used to detect pathogenic microorganism that was not detected.The qualified rate of cleaning at four parts was as following:group A:70.0％,85.0％,93.3％,93.3％.B group:95.0％,98.3％,100.0％,100.0％,and the qualified rate of group B was significantly higher than group A (x2 =12.99,6.98,4.14,4.14,all P ＜ 0.05).Conclusion ATP bioluminescence method can dynamically rapid detect the bacteria before and after intrauterine suction cleaning residues,can be viewed as an effective method to detect quality of uterine suction cleaning.

Objective: To investigate the molecular changes in bladder urothelial carcinoma via different pathways. Methods:Polymerase-chain reaction (PCR) or coamplification at low denaturation temperature-PCR and Sanger direct sequencing were per-formed to detect the status of fgfr3, p53, and h-ras gene mutations in 88 tissue samples of human bladder cancer and 10 normal control tissues. The relative mRNA expression levels of motility-related protein-1 (MRP-1)/CD9 and the relationship between genes and tumor recurrence were also determined. Logistic regression and relative analyses were conducted to compare the significance and interrelation of genes among tumor recurrences. Results:The mutation rate of p53 increased as pathological grades and stages increased. Recurrence rate was higher in patients with MT-p53 genotype than in patients with WT-p53 genotype. Conversely, the mutation rate of fgfr3 gene decreased as pathological grades and stages increased. Recurrence rate was also higher in patients with WT-fgfr3 genotype than in pa-tients with MT-fgfr3 genotype. In low-grade and early stage tumors, MT-fgfr3/WT-p53 was the most prevalent genotype;in high-grade and late stage tumors, WT-fgfr3/MT-p53 was the most prevalent genotype. The mutations of h-ras were mainly observed in low-grade tumors in early stages. Moreover, the relative mRNA levels of MRP-1/CD9 decreased as pathological grades and stages increased. The mRNA levels of MRP-1/CD9 were negatively correlated with p53 mutations and positively correlated with fgfr3 mutations. Logistic re-gression analysis results showed that patients with WT-fgfr3 genotypes exhibited 3.88 times higher relative risk of tumor recurrence than those with MT-fgfr3 genotypes;by contrast, patients with MT-p53 genotypes exhibited 4.53 times higher relative risk of tumor re-currence than those with WT-p53 genotypes. Conclusion:Fgfr3 and h-ras gene mutations may play important roles in tumorigenesis of low-grade and early stage bladder cancer. p53 gene mutation and mRNA levels of MRP-1/CD9 may be implicated in the tumorigenesis of high-grade tumors in late stage of bladder cancer. In general, the two variants of urothelial carcinoma exhibit distinct genetic defects. fgfr3 gene mutation revealed a pathway of favorable prognosis, and p53 gene mutation demonstrated a pathway associated with poor prognosis.