Objective To understand the clinical characteristics during clinical diagnose and treatment of young women patients under 35 years with cervical cancer. Methods The clinical data of 95 cervical cancer patients under 35 years was reviewed and analysed retrospectively. Results The percentage of the patients at this age set was 18. 59% ,accounting for almost one fifth of all the same period patients with cervical cancer. The most common primary clinical representation was sexual bleeding of vigina (90.53% ,86/95) ;28 cases (29. 47%, 28/95) were misdiagnosed by naked eye examination and local treated as cervicitis; 13 cases (13. 68%, 13/95) with severe pathological changes were missed diagnosed by biopsy under colposcopy ;53 cases (55. 79% ,53/95) had their ovary preserved by one or two and had no metastasis or recurrence with carcinoma. Conclusions Sexual intercourse bleeding is the most common manifestation of young women with cervical cancer,which demands more attention. The biopsy under colopscopy has certain limitations,and should be performed along with conization while necessary. It is safe and feasible to retain ovary in cervical cancer patients before Ⅱ stage.

Objective To observe the effectiveness of routine nursing plus foot exercise on the peripheral neuropathy and plantar pressure in patients with diabetic foot.Methods Toally 100 patients with diabetic foot were randomly divided into 2 groups.On the basis of routine nursing care,50 patients in the observation group were given foot exercises for 12 weeks,50 patients in the control group were given routine nursing only.Before and after intervention,the Toronto clinical scoring system (TCSS),left and right foot peak pressure variation were observed.Results Before intervention,there was no statistical difference between the two groups' TCSS sore and the peak pressure of left and right foot (P ＞0.05).After intervention,the observation group's average total score of TCSS was lower,there was significantly different between two groups (P＜ 0.001).The peak pressure of left and right foot is lower in the observation group,the difference was statistically significant (P ＜ 0.05).Conclusion Foot exercises is worthy of clinical promotion,because it can improve the peripheral neuropathy of patients with diabetic foot,so as to reduce the plantar pressure,reduce the pain of patients and improve their life quality.

The establishment of medical morality and behavior appraisal system and research on its application developed in comprehensive hospitals were clarified.Several aspects related to the medical morality and behavior appraisal,such as index,standard,approach,method,record and the result,were investigated and practiced,and the establishment of a scientific and reasonable medical morality and behavior appraisal system was investigated in the aspects of consummating the organization management of medical morality appraisal,subdividing the medical morality appraisal system,quantifying the medical morality appraisal standard,operating and performing the medical morality appraisal and establishing the electronic archives of medical morality appraisal to construct an efficient incentive and restraint mechanism,and moreover,to promote the establishment of hospital convention and the enhancement of the overall management level.

Objective To investigate the effect of different sputum suction methods on the incidences of pulmonary infections in patients with mechanical ventilation.Methods Four hundred and sixty-six patients with mechanical ventilation were randomly divided into study group(n=219)and control group(n=247).The two groups were treated with continued balloon filling and airway humidification.Besides,the control group received conventional open sputum suction and the study group closed continuous negative pressure sputum suction.The two groups were compared in terms of incidence of pulmonary infections.Result The incidence of the study group(8.2%)was significantly lower than that of the control group(14.6%)(χ2=4.58,P<0.05).Conclusion Compared with the traditional open conventional sputum suction method,closed continuous negative pressure sputum suction may be more effective in reducing the incidence of pulmonary infection in patients with mechanical ventilation.

Objective To investigate the applicability of the K~+ concentration in aqueous humor to estimate postmortem interval(PMI).Methods 30 White New-Zealand rabbit were sacrificed by air embolism and divided into 10 groups.Aqueous humor and vitreous humor were sampled at 0.5h,1h,3h,6h,8h,12h,16h,20h,and 24h after death.The concentration of potassium,sodium and calcium were analyzed by an autoanalyzer and the data were statistically processed by SPSS software for Windows.Results Increase in potassiam concentration in aqueous humor was correlated with the postmortem interval(R~2=0.956).Conclusion Measurement of potassium concentration in aqueous humor may be used for PMI estimation.

OBJECTIVETo understanding the molecular mechanisms in invasion and metastasis of the ovarian carcinoma, we investigate a novel candidate metastasis-associated gene (MTA1) and nm23H1 mRNA expression and mutation in ovarian carcinoma.

METHODSTwenty primary ovarian carcinoma specimens, 20 corresponding lymph nodes and 8 normal ovarian was examined for mRNA expression and mutation of MTA1 and nm23H1 genes by reverse-transcription polymerase chain reaction (RT-PCR) and RT-PCR-SSCP analysis. The level of the expression was determined by the relative optic density (ROD) of the PCR products.

RESULTSThe frequency of MAT1 overexpression was 100% (7/7) in primary ovarian carcinoma with metastasis but only 38.5% (5/13) in those without metastasis (P=0.0103). Overexpression of MAT1 was observed in 87.5% (6/7) of lymph nodes with metastasis but only 23% (3/13) of lymph nodes without metastasis (P=0.0118). In contrast with MAT1, low expression of nm23H1 mRNA was seen in 7 of 7 ovarian carcinoma with metastasis but only in 4 of 13 (30%) of those without metastasis (P=0.0043). Low nm23H1 expression was also seen in 7 of 7 lymph nodes with metastasis but only in 5 of 13 (38.5%) nonmetastatic lymph nodes (P=0.0102). The ROD ratio of MAT1 to nm23H1 increased with the development of metastasis. No mutation of MAT1 and nm23H1 genes was found by SSCP analysis.

CONCLUSIONThe mRNA expression of MTA1 and nm23H1 is positively and negatively correlated with lymph node metastasis, respectively. Expression abnormalities but not mutation of the two genes are frequent events related to lymph node metastasis of ovarian cancer.

Female ; Histone Deacetylases ; Humans ; Lymphatic Metastasis ; genetics ; Monomeric GTP-Binding Proteins ; biosynthesis ; genetics ; Mutation ; NM23 Nucleoside Diphosphate Kinases ; Neoplasm Invasiveness ; Neoplasm Proteins ; biosynthesis ; genetics ; Nucleoside-Diphosphate Kinase ; Ovarian Neoplasms ; genetics ; metabolism ; pathology ; RNA, Messenger ; genetics ; Repressor Proteins ; Transcription Factors ; biosynthesis ; genetics

Purpose To explore the correlation between normal pancreas and abdominal aorta in the peak enhancement (PE) and the shift time at the peak by applying the multislices spiral CT perfusion imaging.Materials and Methods Prospectively analyzed 62 patients who received enhancement CT examination for the superior or the middle abdomen,underwent optimum level CT perfusion imaging after plain scanning.These data were processed on a Vitreal 2.0 worker-station by using Toshiba body software package.The time-density curves (TDC) of the normal pancreas and the abdominal aorta were drawn,the PE and the shift time of PE were recorded and their correlation was analyzed.Results Compared with abdominal aorta,the mean value of PE of the normal pancreas was lower,and the difference was statistically significant [(111.94± 14.42)HU vs (351.83 ± 74.93)HU,P＜0.05],the mean difference was (246.10± 65.86)HU.Compared with abdominal aorta,the mean shift times of PE of the normal pancreas was latter,and the difference was statistically significant [(37.56±6.90) s vs (30.82±6.73) s,P＜0.05],the mean difference was (6.54±2.97)s.The PE and shift time of PE of the normal pancreas were positively and linearly correlated with that of abdominal aorta (r=0.438,r=0.379).Conclusion The PE of the normal pancreas is not synchronous with that of the abdominal aorta.The shift time of the former is usually 6～8 seconds slower than that of the latter.This provides a basis to find the PE of the normal pancreas in enhanced scan.

Objective To evaluate the frequency of pncA gene mutations in pyrazinamide-resistant (PZA-resistant)Mycobacterium tuberculosis(M.TB)isolates.Methods The isolates were tested for PZA susceptibility with absolute concentration method.The pncA gene was amplified and the products were cloned into T-vector,followed with sequencing.Results In all the 36 M.TB isolates,there were 25 PZA-resistant strains and 11 PZA-susceptible strains.Mutations of the pncA gene were found in 10 PZA-resistant isolates,four of which belonging to high PZA-resistant strains.The wild type pncA sequence was present in 3 PZA-susceptible strains, synonymous mutations of pncA gene were detected in two PZA-susceptible strains.Additionally,11 PZA-resistant strains and 2 PZA-susceptible ones showed putative regulatory mutations in the upsteam of pncA gene.Condusions The mutation of the pncA gene can cause the PZA resistance.However.there ale other drug resistance mechanism except this mutation.

ObjectiveTo evaluate the influence of electrotome on permanent and temporary cardiac pacemaker in laparoscopic cholecystectomy ( LC),and the application of cardiac pacemaker to the cases of cholecystolithiasis combined with bradyarrhythmia.MethodsClinical data of 215 patients with permanent or temporary cardiac pacemaker who underwent were studied for the preoperative and postoperative variation of pacemaker function,and for the influence of electricity coagulation during the operation on cardiac pacemaker function.ResultsLC was successfully completed in all 215 patients.The function of cardiac pacemaker was not obviously interfered during the operation,and the parameters of cardiac pacemaker did not remarkably change after the operation.ConclusionCardiac pacemaker is slightly interfered when electrotome and electrocoagulation were used in LC; LC is feasible and safe for patients with bradyarrhythmia by placement of cardiac pacemaker.

Objective: To investigate the clinical features, diagnosis and treatment of febrile infection-related epilepsy syndrome (FIRES). Methods: The clinical data of 12 children with FIRES admitted to Xiangya Hospital of Central South University from 2015 to 2018 were retrospectively analyzed. The basic information, clinical manifestations, electroencephalogram, imaging examination, treatment and prognosis were analyzed. Results: Of the 12 patients, 7 were male and 5 were female. The age of onset was (7.0±3.7)years (1.3 year to 13 years). The average hospitalization time (34-86 days, median 52 days). Twelve patients were healthy before the disease, and had fever before convulsion. The interval between fever and seizure was (3.5±1.7)days (1-7 days). The status epilepticus and consciousness deficit were the main clinical manifestations. The electrogram of 8 patients showed status epilepticus when admitted. 12 patients had disturbance of consciousness; the acute episodes were focal seizures (100%, 12/12) and generalized tonic-clonic seizures (41.7%, 5/12). All patients used 3-5 antiepileptic drugs (median 4), all treated with hormones and gamma globulin. 4 patients with ketogenic diet (KD) were treated within 2 weeks of onset, and the average duration from onset to electroencephalogram (EEG) improvement was (19.2±5.0)days. In 8 patients who did not use KD within 2 weeks of onset, the average duration from onset to EEG improvement was (29.9±9.6)days. Conclusions FIRES is more common in normal children with school age. The main manifestation is refractory status epilepticus in the days after acute fever, focal episodes of seizures, anti-epileptic drug resistance. Early initiation of KD produces a favorable prognosis.