Objective To compare the effects on cardiac function between pacings of right outflow tract ( RV-OT) and right vcntricular apex ( RVA) .Methods According to the digital table ,30 patients with high degree atrio-ventricular block which need for permanent pacemaker were randomly divided into the group RVA and group RVOT , 15 cases in each group ,and the DDD or VVI pacemaker was implanted .The programmable pacemakers was carried out,3,12 months after the operation.By Doppler ultrasound,the left and right ventricular synchronization time ,end diastolic diameter ( LVDd) ,left ventricular ejection fraction ( EF) was checked ,ECG QRS wave width ( QRSd) ,6 mi-nutes walking distance (6MWT) was examined.Results Followed up for 12 months,there was no shift,electrode dislocation and other complications .The left and right ventricular synchronization time of group RVOT [(59 ±10)ms] was significantly better that that in the RVA group [(80 ±11)ms](P<0.05).Following up,the EF[(60 ±4)%], LVDd[(45 ±6)mm],6MWT[440 ±10)m]in RVOT group after operation were better than [(48 ±5)%,(54 ±7) mm,(380 ±13)m](all P<0.05),the QRSd of RVOT group[(134 ±9)ms]was significantly shortened than that of group RVA[(186 ±20)ms](P<0.05).Conclusion RVOT septum pacing can be more effective in cardiac func-tion than RVA pacing .

AIM: In this article, gastrointestinal tumor-related historical archives of pathology in our hospital were reviewed in order to acknowledge gastrointestinal stromal tumors (GIST). METHODS: These cases were rediagnosed correctly , these tissues were labeled with some antibodies such as CD117, CD34, ?-SMA, S-100, and their clinical characteristics were explored. RESULTS: CD117, CD34 were expressed widely in GISTs ,the percentage of positive expression was CD117 (50/56, 89.3%), CD34 (37/56, 66.1%), respectively, ?-SMA, S-100 were (17/56, 30.4%), (4/56, 7.1%), respectively, desmin was negative in these cases. Among them, 29 cases were benign and borderline, 27 cases were malignant. The percentage of occurring in stomach and intestine was 91.1%. CONCLUSION: CD117, CD34 are expressed significantly in GIST, these might be assistant markers for GIST diagnosis. GISTs mostly occurred in stomach and intestine.

OBJECTIVE:To survey utilization of traditional Chinese medicine(TCM)combined with western medicine for TCM outpatients in our hospital and to probe into pharmaceutical care in order to decrease and prevent druginduced diseases because of irrational use of drug and provide reference for safe use of TCM combined with western medicine in the clinic. METHODS:100 cases were collected from TCM department from Jan. 1 to Dec. 31 of 2009 and their prescriptions were recorded. General information in prescriptions were recorded and analyzed. RESULTS:1 200 cases of patients there were 909 patients(75.75%) using the combination therapy,136 patients(11.33%)while use of proprietary Chinese medicines,Chinese herbal medicine and western medicine. There are 655 cases of combination therapy patients(72.06%)for rational use of medicines,while 254 patients (27.94%)are not. CONCLUSION:TCM outpatients in our hospital are treated with TCM combined western medicine in general (Chinese patent medicine combined with western medicine). There is some inappropriate use of drugs so that pharmaceutical care is necessary. Drug combination is the key to pharmaceutical care.

Objective To compare the effects of transabdominal hysterectomy(TAH),transvaginal hysterectomy(TVH),and laparoscopic assisted vaginal hysterectomy(LAVH).Methods Clinical data of 48 cases of TAH(TAH Group),38 cases of TVH(TVH Group),and 31 cases of LAVH(LAVH Group) were retrospectively analyzed.Results The operation time was shorter in the TAH Group(73.7?5.9 min) than in the TVH Group(80.9?7.0 min) and the LAVH Group(129.3?9.1 min)(F=612.04,P=0.000).The intraoperative blood loss was greater in the LAVH Group(142.8?17.1 ml) than in the TAH Group(128.1?9.6 ml) and the TVH Group(129.7?10.2 ml)(F=15.18,P=0.000).The postoperative analgesic requirement rate was higher in the TAH Group(75.4%,36 cases) than in the TVH Group(30.2%,11 cases) and the LAVH Group(38.4%,12 cases)(?~2=20.310,P=0.000).The length of postoperative hospitalization was longer in the TAH Group(7.3?1.6 d) than in the TVH Group(4.8?1.0 d) and the LAVH Group(5.1?1.1 d)(F=47.07,P=0.000).The postoperative pyrexia rates were not significantly different among the TAH Group(8.4%,4 cases),the TVH Group(7.4%,3 cases),and the LAVH Group(8.2%,3 cases)((?~2=0.074,) P=0.964).Conclusions As compared with transabdominal hysterectomy,transvaginal hysterectomy and laparoscopic assisted vaginal hysterectomy show advantages of less invasion,less pain,and quicker recovery.

Culture ; Drugs, Chinese Herbal ; Formularies as Topic ; Humans ; Language ; Medicine, Chinese Traditional ; Tablets ; Translations

Case discussion is an effective approach,which combines basic theory with clinical medicine.It can evoke students' interest and cultivate their creative thinking capacity.Moreover,it can improve teachers' general ability in teaching pathophysiolo- gy.In this article,we discuss the application of case discussion in pathophysiology teaching.

Adult ; Aged ; Humans ; Male ; Papilloma, Inverted ; Paranasal Sinus Neoplasms ; Sphenoid Sinus ; pathology

Objective:To investigate the preparation of paclitaxel-loaded nanoparticles targeting liver cancer stem cells and their effects on liver cancer HepG2 cells (CD133 positive subset accounting for 8%) and Huh-7 cells (CD133 positive subset accounting for 65%).Methods:Poly (lactic-co-glycolic acid)-loaded paclitaxel nanoparticles were prepared by using emulsification-solvent evaporation method. Paclitaxel-loaded nanoparticles decorated with anti-CD133 antibody, called targeted nanoparticles, were prepared by using 1- (3-dimethylaminopropyl)-3-ethylcarbodiimide/N-hydroxysuccinimide (EDC/NHS) cross-linking method. The manifestations and physicochemical characteristics of the nanoparticles including encapsulation efficiency, loading efficiency, particle size distribution, morphology and release in vitro were studied. Liver cancer Huh-7 and HepG2 cells accompanying with paclitaxel-loaded nanoparticles or targeted nanoparticles were cocultured. The uptake and accumulation of nanoparticles by liver cancer cells were analyzed by using flow cytometry, and positive cell proportion of CD133 was also detected. Cell survival was analyzed by using plate clonogenesis assay.Results:Scan electromicroscopy result showed particle size of targeted nanoparticles was (429.26±41.53) nm with zeta potential of -11.2 mV; targeted nanoparticles were possessed with spherical morphology and higher encapsulation efficiency [(87.53±5.90) %]. Flow cytometry showed that in Huh-7 cells at 37℃, the fluorescence intensity of targeted nanoparticles group (13 397±720) was higher than that of paclitaxel-loaded nanoparticles group (6 898±604), and the difference was statistically significant ( P < 0.05); there was no statistically difference in the fluorescence intensity of HepG2 cells in paclitaxel-loaded nanoparticles group and targeted nanoparticles group at 37 ℃ (7 899±343 vs. 8 432±516, P>0.05). CD133 positive cell proportion of Huh-7 cells in targeted nanoparticles group [(15.7±2.6)%] was lower than that in paclitaxel-loaded nanoparticles group [(54.9±7.4)%], and the difference was statistically significant ( t = 7.31, P = 0.008); there was no statistical difference of HepG2 cells between the two goups ( P > 0.05). Plate clonogenesis assay showed that the cell survival rate of Huh-7 cells in targeted nanoparticles group was lower than that in paclitaxel-loaded nanoparticles group at different time points, and the difference was statistically significant ( F = 5.56, P = 0.009); but there was no statistically significant difference in HepG2 cell survival rate between the two groups ( F = 1. 19, P = 0.142). Conclusion:Prepared nanoparticles targeting liver cancer stem cells have a good inhibitory effect on liver cancer Huh-7 cells.

Objective To analyze the features of hidden blood loss in the elderly femoral intertrochanteric fractures treated with extramedullary dynamic hip screw (DHS), intramedullary nails (Gamma 3, PFN) and hip arthroplasty (LBFH). Methods The clinicle records of 193 elderly patients (ages ≥75 year old) with femoral intertrochanteric fractures treat by DHS,Gamma3, PFNA and LBFH in our hospital were retrospectively analyzed. The estimated blood loss were calculated by Gross equation, according to the height,weight and changes of blood routine test reoperative and postoperative,the differences of hidden blood loss among DHS group,Gamma 3 group, PFN group and LBFH group were compared. Results Total blood loss in intramedullary nail groups were significantly higher than DHS group [(766 ± 83) mL],P < 0.05). No significant difference was found between PFN group [(887 ± 75) mL] and Gamma 3 group [(903 ± 91) mL] (P > 0.05), The hidden blood loss were significantly higher in the intramedullary nail groups than those in the LBFH group [(453 ± 98) mL,accounting 54%] and DHS group [(429 ± 59) mL,accounting 56%] (P < 0.05). No significant difference of hidden blood loss was found between Gamma 3 group [(742 ± 137) mL, accounting 82%] and PFN group [(711 ± 153) mL,accounting 80%], (P > 0.05). Conclusion Noteworthy, the hidden blood loss is major part of perioperative total blood loss in the elderly femoral intertrochanteric fractures , intramedullary fixations may result in greater hidden blood loss than extramedullary fixations and hip arthroplasty ,which may cause postoperative anemia.

Objective To investigate cognitive status of nursing students for patient safety and analyze its influencing factors,and to supply reference for the patient safety education of nursing students.Methods Using convenience sampling method,617 nursing students in Tianjin and Fuzhou were investigated by self-designed the nursing students for patient safety KABP questionnaire.The results underwent analysis.Results The patient safety KABP total score was 3.34±0.44,all dimensions from high to low were attitude 3.82±0.51,behaviour and practice 3.42±0.60,knowledge 2.92±0.67.Undergraduate nursing students overall cognition was lower than those of college nursing students,t=5.194,P＜0.01,the overall cognitive situation of students who had entered the graduation practice was higher than nursing students who had not entered the graduation practice,t=3.264,P＜0.01,however attitude was negative,t=-3.813,P＜0.01.Regression analysis showed that factors influencing cognition of nursing students for patient safety were mainly education degree and whether entering graduation practice or not.Conclusions The cognition of patient safety in nursing students was in the medium level,mainly affected by the education degree and whether entering graduation practice or not.