Clinical Medicine ; Humans ; Integrative Medicine

A series of surveillance and management actions was taken to minimize out-of-plan re-operations. These actions include: 1) Building and completing the surveillance and management mechanism against unplanned re-operations; 2) Building a real-time surveillance and reporting mechanism; 3) Enhancing quality control and continuous improvement at the operating departments; 4) Enhancing the supervision on regulations implementation by quality control departments of the hospital; 5) Enhancing quality control for medical records; 6) Building a feedback mechanism for surveillance results; 7) Building a penalty and reward mechanism. Efforts for one year and a half on such surveillance and management proved successful, as the incidence of out-of-plan re-operations fell from 1.7% before these actions to 1.0% afterwards.

AIM: To evaluate visual outcome and wearing times in eyes fitted with a rigid gas permeable contact lenses and to assess the role of these lenses in therapeutic contact lens practice.METHODS: Patients fitted with RGP from May 2004 to December 2005 were retrospectively reviewed. Ocular diagnosis,flat and steep curvatures by corneal topography. The data included initial base curve, power, and the number of changes made in parameters during the follow-up. The outcome data included visual acuity and the duration of follow-up and lens wear. Complications and complaints were also noted.RESULTS: Forty-Three eyes of 25 patients had keratoconus were reviewed. The mean age of patients was 19.88 ±3.11years. 26 (60.5%)eyes achieved 20/20 visual acuity;15(34.9%) eyes achieved 20/25 to 20/40; and 1 (2.3%) eyes achieved 20/50 to 20/70. 37 (86.0%) eyes achieved visual improvement. No infection or neovascularization was noted; a corneal abrasion occurred in one eye.CONCLUSION: RGP may be a better alternative in selected patients with keratoconus rather than penetrating keratoplasty.

OBJECTIVE: To establish the diagnosis of amniotic fluid embolism with blood samples by liquid-based cytology technique and to study the validity of method. METHODS: The blood samples were collected from patients who suffered from amniotic fluid embolism. The components of amniotic fluid in blood samples were examined with blood smear by two direct smear methods (supernatant smear, sediment smear) and two liquid-based cytology methods (automatic smear, manual smear). The positive detection rate of each method was calculated. RESULTS: The positive detection rates of two liquid-based cytology methods (84.6% and 92.3%, respectively) were much higher than those of two direct methods (53.8% and 61.5%, respectively). CONCLUSION The liquid-based cytology technique could improve the positive detection rate of amniotic fluid embolism.
Amniotic Fluid ; Cytological Techniques/methods* ; Embolism, Amniotic Fluid/diagnosis* ; Female ; Humans ; Pregnancy

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

OBJECTIVETo explore the effect of arteriosclerosis obliterans (ASO) blood stasis syndrome (BSS) serum on vascular endothelial cell injury and to study the regulation of Taohong Siwu Decoction (TSD) on it.

METHODSUmbilical vein endothelial cell culture system was established. The serum endothelial cell injury model with ASO BSS was prepared. Low, medium, and high concentrations TSD containing serums were respectively added. The endothelial cell proliferation activity was observed by MTT method. Ultrastructures of endothelial cells were observed under transmission electron microscope. Changes of intracellular calcium ion concentration and the cytoskeleton were observed under laser confocal microscope. Contents of ET, NO, and transforming growth factor beta1 (TGF-beta1) in endothelial cell culture supernatant were detected by ELISA.

RESULTSIn ASO BSS serum group endothelial cell proliferation activities decreased, the cell structure was obviously destroyed, calcium ion concentration increased, contents of ET, NO and TGF-beta1 increased significantly (P < 0.01), and ET/NO ratio was imbalanced. After incubating with TSD drug containing serum, endothelial cell proliferation activities and injured cell structures were obviously improved; ET, NO and TGF-beta1 levels decreased (P < 0.05, P < 0.01), ET/NO ratios approximated to the normal level.

CONCLUSIONThe main mechanism of TSD for treating ASO ASS lied in improving injured vascular endothelial cells and endocrine disorder.

Arteriosclerosis Obliterans ; Cell Proliferation ; Drugs, Chinese Herbal ; therapeutic use ; Endothelial Cells ; Humans ; Medicine, Chinese Traditional ; Serum ; Transforming Growth Factor beta1 ; metabolism ; Umbilical Veins

OBJECTIVE To analyze trimethylation of genome-wide histone H3 lysine 4(H3K4met3) induced by silicon dioxide(SiO2)through chromatin immunoprecipitation linked to microarrays(ChIP-chip)in lung fibroblast(LF)of rats. METHODS A primary co-culture model of rat alveolar macrophages (AM)and LF in vitro. AM were exposed to 100 mg · L-1 free SiO2 for 24 h,before LF were collected and the phenotype of LF was determined after transdifferentiation by immunohistochemistry. ChIP-chip was used to profile the variations of trimethylation in H3K4 of lung fibroblasts in CpG island regions. ChIP-qPCR was used to validate the microarray results. The mRNA expression of nfib and kpna3 was analyzed by qRT-PCR. RESULTS Totally 1815 (518 increased and 1297 decreased) genes of H3K4met3 displayed significant differences in SiO2 100 mg·L-1 group compared with control group(Cy3/Cy5 value>2.0 or <0.5,NimbleScan V2.5 software). The results of ChIP-qPCR were quite consistent with those of microarray. CONCLUSION There are significant differences in methylation of genome-wide H3K4 between SiO2 100 mg·L-1 group and control group. These novel candidate genes may become potential biomarkers or new interfered targets.

Objective To investigate the application value of lung ultrasonic on severe high altitude pulmonary edema.Methods A prospective, single-blind, case-control study was conducted. Sixty patients with severe high altitude pulmonary edema admitted to Qinghai University Affiliated Hospital from February 2015 to May 2017 were enrolled. The patients were divided into 2500-3000 m group, 3000-3500 m group and 3500-4200 m group according to different altitudes,with 20 patients in each group. The acute physiology and chronic health evaluationⅡ(APACHEⅡ) score was recorded before and 12 hours and 24 hours after treatment. The arterial partial pressure of oxygen (PaO2) was determined by blood gas analysis, and the oxygenation index (PaO2/FiO2) was calculated. Bedside ultrasound scanning was used to determine B line number and pulmonary artery pressure (PAP), and B line score was calculated to reflect lung water content. The correlation between B line score and PaO2/FiO2, PAP and APACHEⅡ scores at each time point was analyzed by Pearson correlation analysis.Results None of 60 patients died or exited, all of them were enrolled in the final analysis. There was no significant difference in PaO2/FiO2, PAP, APACHEⅡ score or B line score among different altitudes groups (allP > 0.05). Repeated measurement variance analysis showed that the effects of different altitudes on PaO2/FiO2, PAP, APACHEⅡ score and B line score were not statistically significant (F value was 0.312, 0.014, 1.098, 0.236, andP value was 0.340, 0.791, 0.733, and 0.986, respectively). The PaO2/FiO2, PAP, APACHEⅡ score and B line score in all groups were improved obviously from 12 hours after treatment, and the improvements at 24 hours were more than those at 12 hours (allP < 0.05). Repeated measurement variance analysis showed that the effect at different time points on PaO2/FiO2, PAP, APACHEⅡ score and B line score was statistically significant (F value was 1844.270, 121.690, 1173.175, 19426.968, allP < 0.001). The interaction effects of different altitudes and different time points on PaO2/FiO2, PAP, APACHEⅡ score and B line score were not statistically significant (F value was 0.304, 0.404, 1.172, 1.403, andP value was 0.875, 0.805, 0.327, and 0.591, respectively). Pearson correlation analysis showed that there was a significant negative correlation between B line score and PaO2/FiO2 before and after treatment (r value was -0.579, -0.522, and -0.386, allP < 0.01), indicating that the more the B line, the more severe the pulmonary edema, and the worse the oxygenation; with the decrease in B line after treatment, the pulmonary edema was gradually alleviated, and oxygenation was gradually improved. There was a significant positive correlation between B line score and APACHEⅡ score before and 24 hours after treatment (r value was 0.484 and 0.536, bothP < 0.01), indicating that the more the B line, the more severe the patient; with the decrease in B line after treatment, the patient's condition improved after treatment. There was only a weak correlation between B line score and PAP at 24 hours after treatment (r = 0.317,P = 0.014), indicating that PAP was not a sensitive indicator in the degree of pulmonary edema in patients.Conclusions The more the B line in patients with severe high altitude pulmonary edema,the more severe of the pulmonary edema, and the more severe of the patient. There was no significant correlation between the B line score and PAP. Pulmonary ultrasonography can still be used not only in the plain and low elevation areas, but in the high altitude areas, as a reliable method to evaluate the severity of pulmonary edema.

To study the dynamic change law of bioactive constituents from Polygonum multiflorum, and to explore the optimal harvest period of P. multiflorum. Determination of stilhene glucoside, anthraquinones and catechin from P. multiflorum in different harvest times by MEKC-DAD, and principal component analysis (PCA) was used to comprehensive evaluation for bioactive constituents. There are obvious differences among the contents of active ingredients in various collecting periods samples, the content of stilbene glucoside was the highest in November, the total content of combined anthraquinone was the highest in November and December, the content of catechin was the highest in September. The comprehensive evaluation index obtained with principal component analysis showed that the sample collected in November is significantly higher than those with other samples. The optimal harvest period of P. multiflorum is November.
Electrophoresis ; Fallopia multiflora ; chemistry ; growth & development ; metabolism ; Time Factors

OBJECTIVESTo compare the outcomes after liver resection for a single small hepatocellular carcinoma (HCC) (≤ 5 cm) between non-cirrhotic patients and cirrhotic patients, and to explore the influence of liver cirrhosis on recurrence and overall survival after liver resection in patients with a single small HCC.

METHODSA consecutive series of 256 patients with a single small HCC undergoing liver resection from April 2001 to October 2009 was retrospectively reviewed. Among the 256 patients, 227 patients were male, and 29 were female. The medium age was 49 years (ranged, 14 - 79 years); 224 (87.5%) patients were positive for hepatitis B surface antigen, 241 (94.1%) patients were with preoperative liver function of Child-Pugh grade A. The entire cohort were divided into non-cirrhosis group (n = 44) and cirrhosis group (n = 212). Univariate analysis and then multivariate analysis were performed to determine the prognostic factors of recurrence and overall survival after liver resection for all patients.

RESULTSThe 1-, 3-, 5-year recurrence-free survival rates after liver resection were 93.0%, 85.3%, and 68.5%, respectively, in non-cirrhosis group, while 81.1%, 58.6%, and 45.0%, respectively, in cirrhosis group. The 1-, 3-, 5-year overall survival rates after liver resection were 100%, 92.5%, and 92.5%, respectively, in non-cirrhosis group, while 93.8%, 78.7%, and 67.8%, respectively, in cirrhosis group. Both the recurrence-free survival and overall survival of non-cirrhosis group were significantly better than those of cirrhosis group (χ(2) = 8.756, P = 0.003; χ(2) = 8.603, P = 0.003). Cirrhosis, absence of tumor capsule, presence of microvascular invasion and moderate/poor tumor differentiation were the independent adverse prognostic factors for recurrence-free survival and overall survival in patients with a single small HCC after liver resection.

CONCLUSIONSCirrhosis is an important adverse prognostic factor for long-term survival in patients with a single small HCC after liver resection. Liver resection resulted in much worse survival for cirrhotic patients compared to non-cirrhotic patients.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; complications ; mortality ; pathology ; Female ; Hepatectomy ; Humans ; Liver Cirrhosis ; complications ; mortality ; pathology ; Liver Neoplasms ; complications ; mortality ; pathology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult