Objective To explore the efficiency of writing admissions records with the electronic medical record system. Methods 16 interns with the same educational backgrounds and residency periods were randomized into 2 groups and wrote admissions records respectively with the electronic system and by hand, the traditional method. 1 week later, the same records were again written by the two groups, now each using the other's method. The time for completing each part of the records was noted down in real time across the entire process. The time taken by the interns to complete the records was changed into marks of speed, the assessments of the records by experts were changed into marks of quality, and composite marks resulted from the two after weighting. Statistical testing was done with the two methods. Results In terms of time, the average total time taken by the electronic and traditional groups was respectively 19. 85 m and 39. 49 m; in terms of quality, the electronic group got higher marks in scores for present, past, personal, and family histories and physical examination and in the overall score; in terms of general efficiency, the electronic group got average marks of 91. 13 while the traditional group got average marks of 65. 72, the difference being statistically significant (P

Culturing objective and curriculum system for rural order directed free medical students were proposed scientifically and detail measure in designing general course module , basic course module, clinical course module, preventive care course module and professional practice module were put forward based on the analysis of guiding ideology of training rural order directed free medical educational talents.

Early diagnosis of sepsis helps make effective clinical decisions and improve the survival rate of patients with severe infection. However, the timely and accurate diagnosis of sepsis is still a great challenge in clinic. In order to settle the very problem, the scientists in the world have made a lot of exploration and research in the field of rapid molecular identification of pathogens. Nowadays, the nucleic acid detection of sepsis is mainly composed of 3 types of methodological strategies, either based on positive blood culture, single colonies, or directly on blood specimens. This paper presents a comprehensive overview of advances in the research of early detection of bacterial nucleic acid as molecular diagnosis of sepsis.
DNA, Bacterial ; blood ; Humans ; Sepsis ; blood ; diagnosis

AIM:To investigate the mammalian target of rapamycin ( mTOR) signaling pathway as the center playing a role in the crizotinib-induced apoptosis of non-small cell lung cancer (NSCLC) cell line H2228, which represents positive echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene. METHODS:H2228 cells were processed according to different purposes .Fluorescence quantitative PCR is used to ob-serve the gene states .MTT assay is used to detect the cell inhibition rates .The cell apoptosis and cell cycle were analyzed by flow cytometry .The expression and activation levels of the key proteins in the mTOR signaling pathway were determined by Western blotting .RESULTS:Crizotinib promoted the apoptosis of H 2228 cells in a time-and dose-dependent manner . Crizotinib blocked the H2228 cells staying at the G1 phase.In apoptotic H2228 cells processed with crizotinib, the activa-tion level of mTOR was decreased , and the activation levels of the key proteins in upstream and downstream of mTOR path -way were both declined .The expression level of the fusion protein EML 4-ALK variant 3 was not affected , but its active form of p-ALK was significantly suppressed .CONCLUSION:mTOR signaling pathway has a certain relationship with the crizotinib-induced apoptosis of lung cancer cell H 2228, which represents positive EML4-ALK fusion gene.

Objective To investigate the efficacy of zoledronic acid in the treatment of senile unstable femoral intertrochanteric fractures with anatomical locking plate. Methods 67 patients were randomly divided into two groups. Five days after the operation, group A received one intravenous injection of 5 mg zoledronic acid, while patients in group B did not receive the injection. The two groups were compared in terms of hospitalization time, complications, limb weight-bearing time, fracture healing time, hip function score after operation, preoperative and postoperative serum calcium and serum ALP, bone mineral density of proximal femur before operation and 1 year after operation. Results There were no statistically significant differences between the two groups in age, type of fracture, hospital stay, partial weight-bearing time, fracture healing time, hip function at 1 month and 1 year after operation, preoperative bone mineral density and blood calcium. But the differences were statistically different in hip function at 3 months after operation , averaged bone mineral density of proximal femur and serum ALP 1 year after operation. Moreover, 5 patients in group A developed muscle pain or fever after intravenous injection of zoledronic acid. Conclusion The locking plate combined with zoledronic acid injection in treatment of elderly patients with unstable femoral intertrochanteric fracture could inhibit bone loss, increase bone mineral density, and accelerate limb function recovery after operation. On the other hand, Zoledronic acid has a high incidence of adverse reaction.

Aged ; Coal Mining ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; diagnostic imaging ; Pulmonary Heart Disease ; diagnostic imaging ; etiology ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods

Aim To establish the methods for exosomes isolation from the cell culture medium based on the principle of polyethy-lene glycol (PEG) precipitation combined with ultra-high speed centrifugation. Methods Exosomes were extracted by different centrifugation, PEG6000 precipitation combined with ultra-high speed centrifugation and EXO Quick kit,respectively. The mor-phology and particle size of exosomes were analyzed by transmis-sion electron microscopy,NanoSight ZS and Nano-particle track-er(NTA). Western blot assay was used to identify if the extrac-tion were exosomes. Results According to PEG6000 precipita-tion combined with ultra-high speed centrifugation method, the exosomes were successfully isolated from the culture medium. The morphology and particle size of exosomes,the exosomes iso-lated from PEG6000 precipitation combined with ultra-high speed centrifugation were equal to those of the ultra-high speed centrifugation but smaller to EXO Quick kit. What's more, the results of transmission electron microscopy showed that the three methods had typical discoid vesicles. Conclusion The im-provement of the exosome isolation from cell culture medium is convenient,easy and cheap.

OBJECTIVETo explore the efficacy of PSC 833 on multidrug resistance (MDR) reversal and its mechanism.

METHODSHuman erythroleukemic cell line K562 and its doxorubicin-resistant counterpart K562/A02 were used in the study. Cytotoxicity was assessed by MTT assay, P-gp expression by direct immunofluorescence and mdr1 mRNA expression by reverse transcriptase polymerase chain reaction (RT-PCR) with beta-actin as internal control. Intracellular DNR retention was measured with flow cytometry.

RESULTSK562/A02 cells displayed high levels of mdr1 mRNA and P-glycoprotein and reduced DNR retention compared to their parental K562 cells. 1 micromol/L of PSC 833 had no effect on the levels of mdr1 mRNA and P-gp expression in K562/A02 cells (P > 0.05). PSC 833 conferred a dose-dependent increase on chemosensitivity of K562/A02 to DNR, and its effect was at least 3-fold more potent than that of CsA or Ver. PSC 833 could increase DNR retention in K562/A02 cells. A 100.9% restoration of intracellular DNR retention of the level of K562 cells was gained by PSC 833 at 1.0 micromol/L in K562/A02 cells, whereas only a 86.9% restoration of DNR retention was obtained by CsA at 10 micromol/L in the K562/A02 cells. No effect on DNR sensitivity and retention was found in K562 cells (P > 0.05).

CONCLUSIONPSC 833 is at least 3 approximately 10 fold more potent than CsA or Ver with respect to MDR reversing activity, and it may function by inhibiting the function of P-gp and not reducing the levels of mdr1 mRNA and P-gp directly.

ATP-Binding Cassette, Sub-Family B, Member 1 ; drug effects ; genetics ; metabolism ; Calcium Channel Blockers ; pharmacology ; Cyclosporine ; pharmacology ; Cyclosporins ; pharmacology ; Dose-Response Relationship, Drug ; Drug Resistance, Neoplasm ; Humans ; K562 Cells ; cytology ; drug effects ; metabolism ; RNA, Messenger ; drug effects ; genetics ; metabolism ; Verapamil ; pharmacology

OBJECTIVETo investigate the effect of lymphadenectomy adjacent to inferior mesenteric artery root on the prognosis of rectal cancer.

METHODSClinicopathological data of 260 cases with rectal cancer undergone radical operation were analyzed retrospectively. The patients were divided into two groups. Group D(2): the lymph nodes adjacent to mesenteric artery root were not excised (n=188). Group D(3): the lymph nodes adjacent to mesenteric artery root were excised (n=72). Prognosis of two groups was compared during the follow-up period.

RESULTSIn group D(2), the 1-, 3-, 5-year total survival rates (TS) were 97.3%, 87.2% and 77.1%, and tumor-free survival rates (TFS) were 93.1%, 83.0% and 76.8% respectively. In group D(3 ), the 1-, 3-, 5-year total survival rates (TS) were 94.4%, 79.2% and 73.6%, and tumor-free survival rates (TFS) were 86.1%, 76.4% and 71.0% respectively. The differences of TS and TFS between two groups were not significant according to Kaplan-Meier analysis (P>0.05). Multivariate analysis revealed that the excision of lymph nodes adjacent to mesenteric artery root was not statistically correlated with the recurrence, metastasis and survival time after radical operation of rectal cancer.

CONCLUSIONExcision of lymph nodes adjacent to inferior mesenteric artery root has no significant impact on prognosis and it is unnecessary in the radical operation of rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; methods ; mortality ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; Male ; Mesenteric Artery, Inferior ; surgery ; Middle Aged ; Prognosis ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Survival Rate ; Treatment Outcome

Adenocarcinoma ; blood supply ; physiopathology ; Capillaries ; metabolism ; ultrastructure ; Cell Separation ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; ultrastructure ; Humans ; Microcirculation ; Stomach Neoplasms ; blood supply ; physiopathology