Objective To investigate the application effect of quality control management in the prevention of indwelling catheter associated urinary tract infection in intensive care unit (ICU) patients. Methods Cases of patients stayed in the department of ICU undergoing indwelling catheter over 10 d were selected by using time stage sampling method. Totally 136 cases of patients were selected from January 1, 2012 to December 31, 2012, as the control group. A total of 145 cases of patients were selected from January 1, 2013 to December 31, 2013, as the performance group. Cases in performance group were taken standardized training and quantify the performance appraisal on the basis of measures in the control group. The urine routine was tested and bacterial was cultured at indwelling catheter 3 d, 7 d and 10 d, respectively. The indwelling catheter associated urinary tract infections of the two groups were compared. Results After the implementation of the performance appraisal management, the incidences of indwelling catheter associated urinary tract infection at 3 d, 7 d and 10 d were 4.8%(7/145), 19.3% (28/145) and 32.4% (47/145), respectively. Within each quarter, the incidence of indwelling catheter associated urinary tract infection was rising with indwelling catheter time prolonged. And the incidences of the first and second quarter were higher than three and four quarter. The incidences of indwelling catheter associated urinary tract infections at 3 d, 7 d and 10 d in the performance group were lower than the control group, the differences were statistically significant (χ2=4.494, 30.660 and 49.307, P < 0.05). Conclusions Standardized training of nursing staff in ICU and implementation of performance appraisal management could effectively improve the enthusiasm and sense of responsibility of the nurses, and effectively reduce the incidence of indwelling catheter associated urinary tract infection.

Objective To investigate the risk factors of contrast-induced nephropathy (CIN) in patients after coronary angiography.Methods Two hundred patients underwent coronary angiography were enrolled in this study.The patients were divided into CIN group and non-CIN group according to the occurrence of CIN after coronary angiography of 48-72 h,and then the related risk factors of CIN were analyzed.Results Thirteen cases of CIN were found in 200 patients,and the occurrence rate was 6.5％(13/200).Logistic regression analysis showed that risk factors of CIN included primary renal insufficiency,diabetes,contrast agent dose and advanced age (P ＜ 0.05).Conclusion Primary renal insufficiency,diabetes,contrast agent dose and advanced age are risk factors of CIN in patients after coronary angiography.

Hepatic tumor-specific magnetic resonance (MR) enhancement with Gd-EOB-DTPA can detect and distinguish small hepatocellular carcinoma (HCC) with greater sensitivity than conventional magnetic resonance imaging and computed tomography.Hepatic tumor-specific MR enhancement with Gd-EOB-DTPA is more sensitive in detecting focal HCC,and more reliable in detecting lesions with a diameter smaller than 2cm.Gd-EOB-DTPA is excreted through the kidneys and biliary tract,and thus may provide more information about anatomic structures,demonstrate non-obstruction of the intra- and extrahepatic bile duct system,and provide information about hepatic function.

Drug Resistance, Viral ; genetics ; Hepatitis B virus ; drug effects ; genetics ; Mutation

Vasovagal syncope (VVS)is the most common clinical unexplained syncope,and its pathogenesis has not been fully understood yet.The contradictory reflection of cardiac autonomic nervous system caused by riggerring Bezold-Jarisch reflex,which could cause dilated blood vessels,blood pressure and cardiac output decreased,insufficient blood supply to the brain relate with syncope occurrence.Currently,most people consider it mainly relatel to the age and gender of patients,history of syncope,family history,mental and psychological factors,dietary habits and other factors,but the exact risk factors of VVS remains further study of multi-center and a large sample of data.

Objective To explore the changes in β-catenin expression and their significance in ultraviolet ray (UV)-induced development of skin tumor in mice.Methods The back of 60 mice was irradiated for various durations to establish tumor models.Ten mice receiving no irradiation served as the control.Fifteen mice were sacrificed respectively on week 2,4,6 and 8 after the beginning of irradiation and skin tissue specimens were resected from the back of these mice.Hematoxylin and eosin staining was conducted to observe the histopathological changes of skin,and immunohistochemistry and real time fluorescence PCR were carried out to detect the expression of β-catenin.Results Along with the UV irradiation,the exposed skin experienced a series of histological changes.The β-catenin expression was located in cell membrane in unirradiated mice and those irradiated for 2 weeks.There was an attenuation in the expression of β-catenin in cell membrane but an increment in the ectopic expression of β-catenin in 7,9 and 9 of the 15 mice receiving 4-,6- and 8-week irradiation respectively.Compared with the control mice,a significant increase was observed in the ectopic expression rate of β-catenin in mice receiving 4,6 and 8 weeks of irradiation (all P ＜ 0.045).The relative expression level of β-catenin mRNA was 4.893,7.857,10.452,12.481 and 14.702 in unirradiated mice,mice receiving 2,4,6 and 8 weeks of irradiation,respectively,with statistical differences between the 5 groups (all P ＜ 0.05).Conclusions There is an ectopic nuclear expression of β-catenin in cells of UV-irradiated mouse skin,which may be involved in the initiation and progression of skin tumors.

To try to find out the possible use of histochemistry in the prenatal diagnosis in first trimester of pregnancy, 20 kinds of enzymes in chorionic villi from 6th to 9th week of gestation which are related to inborn errors of metabolism were investigated and graded according to their histochemical reactive intensity; the enzymes listed below: (1). ?-glucuronidase, (2). ?-galactosidase, (3). arylsulfatase, (4). ?-N-acetylglucosaminidase, (5). 3?-hydroxysteroid dehydrogenase, (6). NADH dehydrogenase, (7). adenosine triphosphatase, (8). alkaline phosphatase,(9). acid phosphatase, (10). creatine phosphokinase, (11). glutamic dehydrogenase, (12). aldolase, (13). xylitol dehydrogenase, (14). alcohol dehydrogenase, (15). xanthine oxidase, (16). catalase, (17). ornithine carbamoyl transferase, (18). lipase, (19). cholinesterase, (20). ?-glutamyl transpeptidase. The experimental results show that the last 6 kinds of enzymes present negative reactions. Since the his- tochemical reactions of the first 14 kinds of enzymes are positive, it is possible that they can be used for the prenatal diagnosis of inborn errors of metabolism caused by dificiency of corresponding enzymes. The results also show that compared with biochemical method, histochemical method has the advantages of requiring smaller amount of chorionic villi, being without contamination by maternal cells, simplicity and rapidity.

Functional constipation(FC) in childhood is characterized by a low defecation frequency in combination with either involuntary loss of stools(encopresis),passage of large amounts of stool,retentive posturing,or hard and often painful defecation.It represents 3%-5% of general pediatric outpatient visits and up to 25% of pediatric gastroenterology consultations.FC is a diagnosis made by history and physical examination.No testing is necessary or desirable.The decision to seek medical care for symptoms arises from a parent′s or caretaker′s concern for children.The caretaker′s threshold for concern varies with his or her experiences and expectations,coping style,and perception of illness,till now there is not an universal native criteria established in spite of much has been done in it.The criteria used are still to draw assistance from the foreign standard,among which the classic criteria,the Rome Ⅱ and Rome Ⅲ criteria are considered commonly used.The purpose of this paper is to descript the several foreign criteria,and to make comparison among them,and to explore their applicability and effectiveness in childhood FC

Aromatase inhibitors(AIs) are standard therpy for postmenopausal women with estrogen responsive breast cancers.By inhibiting the aromatase enzyme,causing decreases in endogenous estrogens,the treatment of Als is responsible for lower bone mineral density(BMD) and increased fractures.Therefore,early recognition, prevention,and/or treatment of AI-induced bone loss is needed.Zoledronic acid is specific inhibitors of osteoclasts and extensively used in bone metastasis patients.Recently, there are several trials evaluating the use of in- travenous zoledronic acid as prevention and treatment of AI-induced bone loss in postmenopausal women with breast cancer.In this article, we aim to review the use of zoledronic acid in this population including the response and safety.

OBJECTIVE:To observe the occurrence of severe myelosuppression after chemotherapy and to improve its therapeutic effects. METHODS:A total of 288 cases of 268 patients with grade Ⅳ bone marrow suppression induced by chemotherapy treatment were analyzed. RESULTS:Of the 288 cases,The median day when absolute neutrophil coun(tANC)