Objective Investigate the effect of applying clinical pathway on the patients undergoing leiomyoma of uterus. Methods As an experimental group of patients, 50 cases of uterine leiomyoma are treated with clinical pathway. By contrast, another 100 cases are treated with the traditional medical care as control group. Results Waiting time for surgery and hospital stay of the experimental group are less than the control group; and the average hospitalization cost of experimental group is lower than the control group (P< 0.01). Conclusions Application of clinical pathway management will regulate the activities of medical treatment, ensure the quality of health care, improve the feeling of patients, increase efficiency of hospital services, reduce the financial burden of patients, increase the hospital social benefits.

AIM: To observe the changes of transient receptor potential channel 5 (TRPC5) in vascular smooth muscle cells ( VSMCs) of apolipoprotein E-knockout ( ApoE-/-) mice and the effect of atorvastatin interference, and to investigate the mechanism of atorvastatin therapy.METHODS:Male ApoE-/-mice at 6 weeks of age were used to establish the atherosclerosis model by feeding with hyperlipidic diet.The mice were randomly divided into model group and atorvastatin group.The mice in atorvastatin group were lavaged with atorvastatin at 20 mg· kg-1 · d-1 , while the mice in model group received normal saline.The healthy C57BL/6J mice with the same age and the same genetic background, feeding with ordinary food, served as control group.At the time points of 14 and 24 weeks, the mice were sacrificed.The serum was collected for detecting the lipid levels.The aortic roots of the heart were taken to make paraffin sections with HE staining for measuring and comparing the relative atherosclerotic plaque area in each section.The expression of TRPC5 in VSMCs was examined with immunohistochemical staining.The mRNA levels of TRPC5 in the serum and the thoracoabdom-inal aorta were measured by real-time PCR.RESULTS: Compared with model group, blood lipids in atorvastatin group were significantly decreased, and the formation of plaque under aorta intima also decreased.The protein expression of TR-PC5 in atorvastatin group decreased significantly compared with model group.Compared with 20-week model group, TRPC5 in 30-week model group showed increasing tendency, but has no statistical significance.Compared with 20-week atorvasta-tin group, TRPC5 of 30-week atorvastatin group declined.CONCLUSION: Atorvastatin suppresses TRPC5 expression, thus attenuating atherosclerotic development in ApoE-/-mice.

AIM: To evaluate the association between apolipoprotein E(apoE) gene polymorphism and sporadic Alzheimer's disease (AD). METHOD: A case-control study was undertaken detecting the polymorphism of apoE by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). RESULTS:(1) The frequencies of ?3/4 genotype and ?4 allele in AD were significantly higher than that in age-matched controls( P

Objective To explore metabolic characteristics of and risk factors for newly diagnosed type 2 diabetes mellitus(T2DM) combined with non-alcoholic fatty liver disease (NAFLD).Methods One hundred and forty-two cases of newly diagnosed T2DM were divided into two groups according to whether they have comorbid NAFLD:group A (without NAFLD,n =79) and group B (combined with NAFLD,n =63).Data collected included body height,body weight,blood pressure,fasting plasma glucose (FPG),blood lipid,serum uric acid (UA),HbA1c and fasting insulin,body mass index and insulin resistance index with homeostasis model(HOMA-IR) were calculated to compare the clinical and biochemical parameters between groups A and B.Results (1) The difference of age and blood pressure between groups A and B were not statistical different (P ＞ 0.05).Compared with group A,BMI ((26.79 ± 1.93) kg/m2 vs (24.61 ± 2.46) kg/m2,t =5.76),FINS((15.49±2.44) mU/L vs (13.20±2.17) mU/L),t =5.91),HOMA-IR((6.74± 1.32) vs (5.65 ±1.10),t =5.37),glycerin trimyristate (TG) ((2.94 ± 0.65) mmol/L vs (1.74 ± 0.46) mmol/L),t =12.86),low density lipoprotein cholesterin (LDL-C) ((3.46 ±0.73) mmol/L vs (2.78 ±0.86) mmol/L,t =5.07) and UA((342.41 ±71.49) mmol/L vs (312.98 ±66.24) mmol/L,t =2.54) were significantly higherand hight density lipoprotein cholesterin (HDL-C) ((0.99 ± 0.17) mmol/L vs (1.21 ± 0.29) mmol/L,t =5.33) was significantly lower in group B (P ＜ 0.05).(2) Using whether to combined with NAFLD as dependent variable,and BMI,FINS,HOMA-IR,TG,LDL-C,HDL-C and UA as independent variable,logistics regression analysis showed that BMI,HOMA-IR and TG were risk factors for NAFLD(OR =2.838,19.241,and 2.019 respectively,P ＜ 0.05).Conclusion Newly diagnosed type 2 diabetes mellitus combined with NAFLD have more obvious dyslipidemia and insulin resistance.Obesity,insulin resistance,hyper-triglyceridemia are risk factors for newly diagnosed type 2 diabetes mellitus combined with NAFLD.

OBJECTIVE: To observe the effects of Jianpi Huoxue Decoction, a compound Chinese herbal medicine, on Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and lipopolysaccharide (LPS). METHODS: SD rats were divided into normal, control liquid diet, ethanol liquid diet and ethanol liquid diet plus Jianpi Huoxue Decoction group. Rats were administrated with Jianpi Huoxue Decoction or distilled water via gastrogavage for 4 weeks after administration with ethanol or control liquid diet for 2 weeks respectively. After that, rats in each group were stimulated with LPS via gastrogavage for 3.5 h and harvested. Alanine aminotransferase (ALT) in serum and triglyceride (TG) in liver were analyzed. Pathological changes in liver tissues were observed in HE staining section. Tumor necrosis factor-alpha(TNF-alpha) in portal vein plasma was assayed by ELISA. The protein expressions of CD68, Toll-like receptor 4 (TLR4), phosphorylation-I kappa B (P-I kappa B) and TNF-alpha in liver were evaluated with Western-blotting. RESULTS: After the treatment with Jianpi Huoxue Decoction, the pathologic changes in liver tissue were lightened, levels of ALT in serum, TG in liver and TNF-alpha in portal vein plasma were decreased, and the protein expressions of CD68, TLR4, P-IkappaB and TNF-alpha in liver were reduced. CONCLUSION: Jianpi Huoxue Decoction can inhibit Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and LPS.

OBJECTIVETo explore the clinical manifestations, diagnosis, treatment and prognosis of acute panautonomic neuropathy (APN).

METHODSWe reviewed the history, clinical findings, electrophysiological characteristics, laboratory features of CSF and treatment of 4 patients with APN.

RESULTSAll these patients showed acute onset with apparent involvement of the autonomic nervous system. The clinical features of autonomic involvement included fixed dilated pupils, abdominal pain, diarrhea, and anhidrosis. Electromyography showed evidence of peripheral neuropathy. Early treatment with corticosteroid and intravenous immunoglobulins resulted in improved prognosis of the patients.

CONCLUSIONAPN is a rare autonomic nervous system disorder, and understanding of the clinical features may help in early diagnosis and treatment of the patients.

Acute Disease ; Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Adult ; Autonomic Nervous System Diseases ; diagnosis ; physiopathology ; therapy ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Male ; Young Adult

Objective To establish a real-time quantitative polymerase chain reaction (RQ-PCR) assay for fast detection of Aspergillus fumigatus genome in human whole blood samples and explore its clinical application.Methods The primers and the TaqMan-probe were designed on the basis of the multi-copy ITS1-5. 8S region of the rDNA of Aspergillus fumigatus. The Aspergillus fumigatus genomic DNA were extracted with QIAamp(R) DNA Blood Mini Kit.A 20 μl RQ-PCR amplification system was established, and the simulated blood samples containing various given load of Aspergillus fumigatus genome and the 66 whole blood samples of the surgical febrile patients were examined. Results The detection limit of the RQ-PCR instrument is 10-1 genomes/μl DNA sample,namely 78 CFU/ml whole blood. The specificity and the sensitivity were 94. 25% and 99. 04% respectively; and the positive predictive value and negative predictive value were 97. 63% and 97. 62% respectively. The average relative error of the quantitative results was (3. 67 ±13. 19)%, and the intra- and the inter-assay average coefficients of variation were (12.38 ± 1. 53)% and (16. 27 ±2. 72)% , respectively. The average recovery rate of Aspergillus fumigatus genomic DNA in human whole blood samples was (107. 81 ±25. 92)% , and the average coefficient of variation of the average recovery rate was (26. 24 ± 5.62) % . No Aspergillus fumigatus genomic DNA was detected among the 66 blood samples of the surgical febrile patients. Conclusions The RQ-PCR assay for fast quantitative detection of Aspergillus fumigatus genome in human whole blood samples is of high sensitivity, specificity,accuracy and precision. The Aspergillus fumigatus genome was not detected in this group of surgical febrile patients.

Objective To investigate the Relationship between the CYP2C19 polymorphism and the efficacy of triple therapy with lansoprazole on Helicobacter pylori infection. Methods 125 elderly patients diagnosed with H.pylori infection were treated with triple therapy. Polymorphism of CYP2C19 was measured by AS-PCR. 105 young patients were selected as control group. The relationship between the polymorphism and eradication rate were analyzed. Results Among the 125 patients,eradication rate of extensive metabolizer group,internal metabolizer group and poor metabolizer groups was 85.29%,76%and 89.39%, respectively. There was no significant difference between groups (P > 0.05). Eradication rate showed no difference between experimental and control group either (P>0.05)(P>0.05). Conclusion The results suggests that the CYP2C19 polymorphism has no correlation with the eradication rate of Helicobacter pylori infection by triple therapy with lansoprazole in elderly patients.

Objective To investigate the anatomy of the superficial epigastric artery perforator flap , and to provide anatomical basis for harvesting flap .Methods Of 27 SD rats, 7 were used for gross anatomy observation and anatomic characteristics and 20 rats for lead oxide-gelatin injection followed by computer picture processing , measurements and the related parameters recording .Results The superficial epigastric artery originated from femoral artery , and gave off its first branch when passed through the superficial fascia .The trunk branched into a lateral perforator and a medial perforator , which anastomosed with thoracodorsal artery and lateral thoracic artery , respectively .The average external diameter of superficial epigastric artery was (0.46 ±0.02)mm at its starting point,and(0.46 ±0.02)mm at the superficial fascia level . The nutritive area of superficial epigastric artery was (18.37 ±3.67) cm2 .The anastomosed area with thoracodorsal artery and lateral thoracic artery was(5.34 ±0.86)cm and(6.28 ±0.29)cm, respectively, away from the horizontal line through axillary,and (4.38 ±0.38)cm and(2.04 ±0.33)cm, respectively, away from the ventral median line.Conclusion The position and external diameter of superficial epigastric artery are constant , and the superficial epigastric artery perforator flap is a ideal flap model for research on free flap transplantation , flap supercharging , and hemodynamics .

Objective To analyze the clinic pathologic factors and survival rate by performing a retro-spective study on the early gastric carcinoma (EGC)with signet ring cell underwent curative gastrostomy (SRC) percentage less than 50%after operation .Methods A total of 424 patients was diagnosed as EGC from January 2008 to January 2010 in Changhai Hospital .The patients were divided into three groups according to the different percentage of SRC within tumor cells , SRC group ( with percentage of SCR more than 50%) , Mixed SRC group (with percentage of SRC less than 50%),and Non-SRC group(Classic adenocarcinoma without SRC ).Then we evaluated the clinic pathologic indicators and prognoses , and study on the relationship with histologic types . Results In ECG,the mixed-SRC group was similar to the SRC group on the phases of onset age and sex .On the other phases,the mixed-SRC group was more associated with mucosa -confined,lower lymph node metasta-sis(LNM),and 5-year survival rate was better than adenocarcinoma group (P<0.05).However,the mixed-SRC group showed more submucosal invasion ,and higher LNM than other groups ( P<0 .05 ) .The mixed-SRC component was one of the independent risk factors of LNM .Conclusion In EGC,mixed-SRC had a more favor-able risk factor of LNM ,showed more aggressive behavior than other groups and displayed poor prognosis .