Objective To investigate the expressions of CXCR4 in Barrett esophagus (BE), esophageal adenocarcinoma (EADC) and esophageal squamous cell carcinoma (ESCC), and its relationship with pathology, clinical staging and lymph node metastasis. Methods The expressions of CXCR4 in 56 cases of normal esophageal mucosa, 80 BE (including 22 BE with multifocal dysplasia), 25 EADC and 48 ESCC were examined with immunohistochemical method. Results CXCR4 was expressed in most samples of BE (80. 8% ), EADC (68. 0% ) and ESCC (78.4%) without significant difference ( P ＞ 0. 05 ), which was significantly higher than that in normal esophageal mucosa (39. 3%, P ＜0. 01 ). The level of CXCR4 expression in BE, EADC or ESCC were not related with gender, age, or location of the foci ( P ＞ 0. 05). There was no significant difference in CXCR4 expression between BE without dysplasia or BE with multifocal dysplasia ( P ＞ 0. 05 ). CXCR4 expression level in well-differentiated EADC was significantly higher than that of mild or poorly differentiated (P ＜ 0. 05 ). CXCR4 expression level was higher in EADC with lymph node metastasis than those without ( P ＜ 0. 05 ). CXCR4 level in ESCC with TNM staging grades Ⅲ -Ⅳ was higher than that of grades Ⅰ - Ⅱ, and this variable was also higher in cases with lymph node metastasis than those without (P ＜ 0. 05), so was the case of well and poorly differentiated ESCC (P ＜ 0. 01 ). Conclusion Increased expression level of CXCR4 may be a common feature of EADC and ESCC, which is irrelevant to pathological types. CXCR4 level rises at the stage of BE, which is associated with the degree of tumor differentiation, lymph node metastasis and TNM staging. CXCR4 expression is of guiding significance in the diagnosis of BE, EADC and ESCC, and is the potential drug target.

Career Mobility ; China ; Humans ; Occupational Diseases ; epidemiology ; prevention & control ; Occupational Exposure ; prevention & control ; statistics & numerical data ; Occupational Health

Adult ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; standards ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Occupational Health Services ; standards ; Young Adult

Adult ; Female ; Humans ; Logistic Models ; Male ; Mental Health ; statistics & numerical data ; Transients and Migrants ; psychology ; Young Adult

Objective To provide a scientific reference for the choice of antimicrobial drugs by analyzing the distributions and the antimicrobial resistances of Carbapenem‐resistant Acinetobacter baumannii (CR‐AB) and methicillin‐resistant Staphylococcus au‐reus (MRSA) in the Northern Jiangsu People′s Hospital .Methods All the CR‐AB and the MRSA isolated from hospitalized pa‐tients from January 2011 to March 2014 were collected and analyzed .Use the disk diffusion method for antimicrobial resistance tes‐ting .Results A total of 170 CR‐AB strains and 168 MRSA strains were isolated .CR‐AB mainly distributed in the ICU ,which ac‐counting for 61 .17% (104/170) .MRSA mainly isolated in neurosurgery ,about 27 .98% (47/168) .67 .06% of CR‐AB strains and 54 .17% of MRSA strains were from Sputum specimens .The antimicrobial resistance rate of CR‐AB to most antimicrobial drugs were reached 50 .00% ,the resistance rates to cefoperazone/sulbactam (27 .65% ) ,minocycline (21 .18% ) ,amikacin (19 .41% ) and tobramycin (12 .35% ) were all less than 30 .00% ,the strain that resistant to polymyxin was not found .The sensitivity rates of MR‐SA to linezolid ,vancomycin ,and tigecycline were 100 .00% ,and the resistance rates to nitrofurantoin and kuinuputing/ dalfopristin were low (less than 2 .00% ) .Conclusion The antimicrobial resistances of CR‐AB and MRSA are serious .In order to control effec‐tively the spreading of CR‐AB ,MRSA and other multi‐drug resistant bacteria ,it′s necessary for us to strengthen the management of key departments ,and select antimicrobial drugs based on the results of drug susceptibility testing .

A questionnaire survey on chronic heart failure management was conducted in 110 physicians from Xindu,Supo,Jiajiang and Xinhua community hospital in Chengdu from January 2007 to June 2010.Results showed that 77.3％ (85/110) of community physicians lacked knowledge about prevention,diagnosis and treatment of chronic heart failure,and the diagnostic accuracy rate was only 51.3％ (40/78) in these community hospitals.There was lack of awareness of the guideline of chronic heart failure:the rate of β blockers use was 15.0％ (6/40) and only 5.0％ (2/40) used the target dose; the rate of angiotensin converting enzyme inhibitor use was 17.5％ (7/40) and only 7.50％ (3/40) used the target dose.In addition,90％ (99/110) of community doctors lacked the education and management for patients with heart failure.The survey suggests that the current situation of chronic heart failure management in community physicians in Chengdu is unsatisfactory.It is necessary to strengthen the training of community physicians.

Aim To explore the interaction between nitric oxide( NO) and hydrogen sulfide(H 2S) on the relaxation reactivity of pulmonary arteries in rats.Methods Seven male healthy rats were anaesthesed with chloral hydrate; the pulmonary artery of each rat was removed for the study. Th e reactivities of pulmonary artery rings in response to different doses of NO do nar-sodium nitroprusside(SNP) and H 2S donar-NaHS were measured in vitro.DL-propargylglycine(PPG)and N?-nitor-L-methyl ester(L-NAME) were provided to pulmonary artery, respectively;the relaxation reactivities of pulmonary artery were observed.Results The relaxation reactivities of pulmonary arteries showed a dose-dependent increase in response to different doses of SNP and H 2S.The relaxation reactivity to SNP decreased by PPG. The relaxation reactivity to H 2S decreased by L-NAME.Conclusion H 2S acted as a vasorelaxator either independently or accompanied with NO, SNP acted as a vasorelaxator either independently or accompanied with H 2S;the networ k of gastransmitter played an important role in the relaxation of pulmonary arte ries.

OBJECTIVE: To establish an evidence-based evaluation process of off-label drug use with the guidance of evidence-based medicine to provide decision support for clinical application of off-label drug use. METHODS: With the guidance of evidence-based medicine, the evaluation process of off-label drug use was established according to the requirements of Cochrane handbook 5.1 and the GRADE system. RESULTS: A standardized evidence-based evaluation process was established as follows; first, search and retrieve the evidence; second, assess the risk of bias of the study; third, assess the quality of evidence; last, achieve a consensus on the recommendations of off-label drug use. CONCLUSION: The process of evidence-based evaluation of off-label drug use will provide scientific decision support for Pharmacy Administration Drug and Therapeutics Committee of hospital to decide the clinical application of off-label drug use. It will effectively regulate the management of off-label drug use.

Objective To discuss the histology change,apoptosis state and Bcl-2,Bax expression after the bone cement leakage into the intervertebral disc in vertebroplasty.Methods Eight majority canis familiaris were studied.Three lumbar intervertebral discs(L2 to L5)in each dog were randomly classified into three groups(control group,PMMA group,and CPC group),the canine discs were stabbed by 18-gauge needle,and 0.1 ml cement was injected into them.Control discs were only stabbed and injected with nothing.Histology of all discs was studied 24 weeks after the operation.Terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL)and immunohistochemisty were used to detect apoptosis and Bcl-2,Bax expression in the discs.The data were statistically analyzed by SPSS 12.0.Results Intervertebral disc degeneration was not found in control groups.In bone cement groups,however,ruptured or serpentine patterned fibers,decreased cellularity of the nucleus pulposus and condensed matrix of the nucleus pulposus were found in histologic results.The Bax protein decreased in the order of control group, CPC group,and PMMA group.However,the Bcl-2 protein increased in the order of control group,CPC group,and PMMA group.The histology grade was significantly different among the three groups under ANOVA analysis(P

Objective To investigate the diagnostic value of non-invasive cardiac output parameters:cardiac index (CI) and minute distance (MD), in premature infants with patent ductus arteriosus (PDA) and determine the cut-off value. Methods Clinical data of 98 premature infants admitted to the neonatal intensive care unit from January 2015 to June 2015 were collected. These premature infants were divided into the treated PDA group (n=30),the untreated PDA group (n=28) and the normal premature group (n=40) based on the results of echocardiogram in the first three days after birth and the use of drugs. Non-invasive cardiac output parameters were measured in the first three days after birth. The data were analyzed by t test, analysis of variance and SNK-q test. The diagnostic value of CI and MD for PDA was analyzed by the receiver operating characteristic curve. Results By preliminary analysis of the ROC curve,CI and MD were the most representative parameters for the diagnosis of PDA which need to be treated clinically, we thus chose CI and MD in this study. The aortic and pulmonary arterial CI and MD in the treated PDA group were significantly higher than in the untreated PDA group and the normal premature group (all P<0.05). There were no significant differences between the untreated PDA group and the normal premature group in the aortic and pulmonary arterial CI and MD (all P>0.05). The cut-off value of the aortic CI and MD was 2.95 L/(min·m2) and 21.50 m/min, respectively, while that of the pulmonary arterial CI and MD was 4.55 L/(min·m2) and 26.50 m/min, respectively. The sensitivity and specificity of the combined aortic CI and MD for the treated PDA group were 0.90 and 0.82, and those of combined pulmonary arterial CI and MD were 0.87 and 0.82;and those of combined aortic and pulmonary arterial CI and MD were 0.80 and 0.88, respectively. Conclusions The non-invasive cardiac output parameters CI and MD have good diagnostic value for the PDA needing clinical treatment, and the combined use of the two parameters can improve specificity, and help formulate the early treatment strategy for premature infants with PDA. When aortic CI was ≥ 2.95 L/(min·m2) and MD was ≥ 21.50 m/min, a preliminary diagnosis of the PDA needing clinical treatment, can be made, and simultaneously when the pulmonary arterial CI was ≥4.55 L/(min·m2) and MD was≥26.50 m/min, the arterial duct should be closed timely.