Objective To study the effect of compound nutritional therapy on end-stage liver disease patients with pressure ulcers at Ⅱ phase got from outside the hospital. Methods A total of 101 end-stage liver disease patients with Ⅱ phase pressure ulcers were divided into the observation group (50 cases) and the control group (51 cases) by random digits table method. The control group was treated by conventional diet and drug, and the treatment group was treated by compound nutritional therapy except the conventional diet and drug. The pressure ulcers were assessed daily and the patients were reviewed weekly during treatment. The outcomes of the difference of wound healing and nutritional status improving were compared between the two groups. Results After 14 d treatment, the total of wound healing cure rate was 42.6% (29/68), the total effective rate was 94.1% (64/68) in the observation group, the total of wound healing cure rate was 27.6%(18/65), the total effective rate was 73.8%(48/65) in the control group, and there was significant difference between two groups (χ2=12.726, P=0.005). The healing time was (12.87±2.46) d in the observation group, significantly shorter than that in the control group (17.26±3.51) d, there was significant difference (t=2.760, P=0.005). Conclusions For the end-stage liver disease patients with pressure ulcers at Ⅱ phase got from outside the hospital, compound nutrition therapy can improve the nutritional status, promote the pressure ulcers healing, reduce the economic burden and improve the overall curative effect.

Objective To investigate the expression of Matrix metalloprotein-9 (MMP-9) and Vascular Endothelial Growth Factor (VEGF) in breast cancer. HZ Methods SP immunohistochemistry was used to determine the expression of MMP-9 and VEGF in 96 breast cancer tissues. Results The positive rate of MMP-9 in breast cancer was 65.6 %,while the positive rate of VEGF was 71.9%. Both MMP-9 and VEGF postivity was correlated with pathological stage and lymphatic metastasis.There was a positive correlation between the expression of MMP-9 and that of VEGF in breast cancer tissues( P

OBJECTIVE To study the influence to the sterilizing effect of these factors,which were preheating the sterilizer,the positions of the articles placed and the cleanness of the internal wall.METHODS A total of 120 clinical used dental handpieces,according to the high-pressure steam sterilizer disposal procedure,were divided into four groups,with 30 handpieces in each group.Those only with high-pressure steam sterilizer process were chosen as the control group.Preheating 30 minutes,wipping the internal wall with 0.5% chlorine disinfectant before using high-pressure steam sterilizer and acting both of two steps were all chosen as the experimental groups.Each group was put in the interior,middle and exterior of the high-pressure steam sterilizer separately.The Rapid Readout Biological Indicators(3M Attest,the USA) were used to test the sterilizing effect.RESULTS The different methods of the high-pressure steam sterilizer had the significant differences to the handpieces sterilizing effect(P0.05).CONCLUSIONS To achieve ideal sterilization,it is suggested to wipe the internal wall and the temperature control probe head with 0.5% chlorine disinfectant and preheat the sterilizer for 30 minutes before put handpieces in the high-pressure steam sterilizer.

ObjectiveTo investigate the effect of neuromuscular electrical stimulation (NMES) on salivated children with cerebral palsy. Methods43 salivated children with cerebral palsy were divided into NMES group (n=22) and control group (n=21). Both groups accepted the same routine treatment, while the NMES group was given the NMES in addition. All the children were evaluated before and 8 weeks after treatment with teacher drooling sizing (TDS). ResultsThe TDS of NMES group was significantly different with that of the control group (P<0.05) after treatment. ConclusionNMES can decrease the salivation in children with cerebral palsy, and promote their swallowing function.

Objective To investigate the clinical value of stereotactic biopsy in the diagnosis of the multiple intracranial lesions, and explore the operation methods, technical points and clinical experiences to reduce surgical complications. Methods Twenty-three patients in the first affiliated hospital of Kunming Medical University underwent stereotactic biopsy from January 2009 to June 2013 were analyzed retrospectively. The patients were aged between 11 and 73 years (the mean age of 34.6 years) . There were 12 males and 11 females. Operations were performed by thin thickness of spiral CT scan, ASA-602S and Leksell-Frame-G stereotactic frame, Sedan side-cutting needle, Backlund side-cutting needle and neuroendoscope of STORZ. Routine histopathological examinations of specimens were conducted. The immunohistochemical staining of the histopathological section of specimens was performed if necessary. Results The diagnostic yield was 91.3% (21 cases) . The result of pathological diagnosis was inflammatory granuloma in 1, inflammatory lesion in 1, calcification in 1, hyperplasia of colloid cells in 6, astrocytoma in 1 (WHOⅠ-Ⅱ), astrocytoma in 2 (WHOⅡ), astrocytoma in 1 (WHOⅡ-Ⅲ), mixed oligoastrocytoma in 1 (WHOⅠ-Ⅱ), glioblastoma multiforme in 3 (WHOⅣ), germinoma in 1, brain metastases in 1, diffuse large B-cell lymphoma in 1, intracranial granulomatousarteritis in 1 and negative in 2. There were no serious complications, such as coma, hemiparalysis, infection and intracranial hematoma. Conclusion Stereotactic biopsy is an important method in the diagnose of multiple intracranial lesions. It has the advantages of precise location, less damage, safe performance, and reducing the complication effectively. It is worth promoting.

Objective To investigate the clinical and pathological features of urothelial carcinoma with clear cell variant.Methods The pathological and clinical data of 7 cases pathological diagnosed urothelial carcinoma with clear cell variant between March 2005 and May 2014 were retrospectively reviewed.There were 6 males and 1 female,aged 46-75 years (mean,61 years).Clinical manifestations included gross hematuria in 5 cases,hematuria and backache in another 2 cases.The mean tumor size was 3.5 cm (ranged 2.0-6.0 cm).One case was multiple tumor and 6 cases were single tumor.Five cases were positive in urine cytology.All the 7 cases accepted surgical treatment,including radical nephroureterectomy in 2 cases,transurethral resection of bladder tumor plus pharmorubicin regular intravesicalinstillationin 1 case,and radical cystectomy in 4 patients.Results Pathological findings revealed that all the tumors were high-grade urothelial carcinoma with clear cell variant in different proportion.Among them,clear cell tumor was predominant in 1 case and focal in other 6 cases.Meanwhile,tumorsaccompanied by glandular differentiation were found in 2 cases,squamous differentiation was found in 1 case,and micropapillary variant was found in 1 case.Vascular tumor embolus was found in 4 cases.Pathological stage was pT2a (n =1),pT2b (n =3),and pT3a (n =3).Immunohistochemicalstaining revealed cytokeratin 7 (+),cytokeratin 20 (+),epithelial membrane antigen (+)and prostate specific antigen (-).Six cases were followed up.The bladder preservation case was followed up for 8 months without recurrence.In 3 radical cystectomy cases,1 died of cancer 25 months after surgery and another 2 case were followed up for 10 and 12 months after surgery without recurrence and metastasis.In 2 nephroureterectomy cases,1 died of tumor metastasis 18 months after surgery and the other case was followed up for 6 months without recurrence or metastasis.Conclusions Urothelialcarcinoma with clear cell variant is a malignancy often with advanced stage and poor prognosis.Radical surgery is recommended for the treatment.

Objective To investigate the effects of lipopolysaccharide(LPS) on the tryptophan-kynurenine(TRP) metabolic pathway in rat brains and provide new evidence for the relationship between inflammation and depression.Methods Rats in LPS group were given a single dose of 3.5 mg/kg LPS.while the rats in control group were given the same dosage of saline.The dialysis in ventro-hippocampus were collected by microdialysis within 8 hours and then the TRP,KYN and KA were detected by LC-MS/MS.And the expression of indoleamine 2,3-dioxygenase was detected by Western-blot.Results The level of TRP((550.15± 107.96) pmol/L) and KYN ((337.95±62.73) pmol/L) showed a time-dependent increase after administration LPS 4 h compared with the control group(TRP (368.38±59.31) pmol/L,KYN (172.80±43.96) pmol/L),while KA level in the circulation exhibited a trend to decrease,especially at 7 h ((3.47±0.62) pmol/L,P＜0.05).The ratio of KYN/TRP significantly increased at about 5 h (0.69±0.11,P＜ 0.05),and an ratio of KA/KYN (0.02±0.00) was dramatically decreased after administering LPS 4 h compared with the control group (0.05±0.01)(P＜0.05).Most of the analytes showed more dramatic changes around 4 h to 8 h.LPS group(1.48±0.37) increased the protein expression of indoleamine 2,3-dioxygenase compared with the control group(1.00±0.24) (P＜0.01).Conclusions LPS may cause tryptophan metabolic abnormalities and accelerate the way of kynurenine metabolism,leading to decreased the kynurenic acid status.

Objective:To conduct a survey on the difference in medical staff remuneration level and satisfaction within the eastern, central and western township health centers, explore the influencing factors on remuneration satis-faction, and put forward some suggestions. Methods:909 medical staff and 104 township health centers from 9 coun-ties in the eastern, central and western regions were investigated. The Descriptive, ANOVA and Hierarchical Linear Model ( HLM) methods were used to analyze the survey results. Results:Average annual medical staff remuneration was 28 324 Yuan in 2011 and the remuneration satisfaction was 2. 77 in five-point scale. The difference between the remuneration level (F=140. 16,P<0. 001) and remuneration satisfaction (F=240. 84,P<0. 001) among three re-gions was statistically significant. The HLM analysis indicated that the working time, workload per day in individual level and whether by practicing the policy of separation between revenue and expenditure, the number of average monthly discharged patients and the fiscal appropriation income in the township health centers level affected the remu-neration satisfaction. Conclusions:The medical staff remuneration level and satisfaction in the township health centers were low, both having a great regional difference. Therefore, the improvement of the medical personnel remuneration satisfaction is obtained through improving the revenue and expenditure, and the performance-based pay system.

AIM:To put forward the suggestions for standardizing the pharmacoeconomic research.METHODS:The background of formulation and main points of Canadian Guidelines for the Pharmacoeconomic Evaluation were introduced and its recent development was described.At the same time,we put forward our tentative plan about establishing Chinese guidelines for the pharmacoeconomic evaluation.RESULTS ＆ CONCLUSION:A series of guidelines for the pharmacoeconomic evaluation should be established,which is approved by departments of social safeguard,drug supervision and public health administration,to standardize the pharmacoeconomic research.The goverment should make corresponding policy publicized and make pharmacoeconomic evaluation connect with drug price,clinically rational drug use,catalog of classified management of drugs and catalog of drugs in medical insurance.A pharmacoeconomic framework,which conforms China's national conditions and is controlled by goverment,will established.

Objective To investigate the expression of metastin and its significance in benign breast disease,normal breast tissue and breast carcinoma.Methods SP immunohistochemistry was used to determine the expression of metastin in 16 benign breast disease,12 normal breast tissue and 56 breast carcinoma.Results The positive rates of metastin in benign breast disease,normal breast tissue and breast carcinoma were 68.8%,75% and 30.4%,respectively.The expression of metastin in breast carcinoma was much lower than that in benign breast disease and normal breast tissue(P