Objective To study curative efficacy of carboprost romethamine in treatment of postpartum hemorrhage of pregnancy and its effects on fibrinogen(FIB) and D-dimer(D-D).Methods106 patients of chronic renal failure who received therapy from November 2015 to November 2016 in our hospital were selected.According to random number table, those patients were divided into the observation group (n=53) and the control group (n=53).The control group was treated with oxytocin after delivery, while the observation group was treated with carboprost romethamine.The postoperative 2h and 24h bleeding volume, contraction duration, duration of lochia, uterus decreased speed and the changes of FIB and D-D before and after treatment were compared, and comparison of adverse reactions.ResultsThe postoperative 2h and 24h bleeding volume in the observation group were significantly lower than those in the control group[(231.58±36.79)mL vs (345.62±45.60)mL, (301.24±44.01)mL vs (445.23±61.74)mL] (P<0.05);compared with the control group, the observation group contraction duration longer, duration of lochia was shorter, uterus decreased was faster(P<0.05);before treatment, there was no significant difference in FIB and D-D between the two groups;after treatment, the levels of FIB and D-D in the control group did not change significantly;the levels of FIB and D-D in the observation group were significantly reduce, and the result were lower than those in the control group(P<0.05);there was no significant difference in the incidence of nausea and vomiting, chest pain, chills between the two groups.ConclusionCarboprost romethamine is well for postpartum hemorrhage of pregnancy, which can effectively improve blood hypercoagulable state, reduce the amount of postpartum hemorrhage, it's worthy of application and promotion.

Objective To profile the omp1 genotypes of Chlamydia trachomatis (Ct) in patients with nongonococcal urethritis (cervicitis) in Guangzhou region. Methods Swab samples were obtained from the urethra of males and cervix of females in clinical settings of venereology and gynecology as well as at outreach sites for the prevention and control of sexually transmitted diseases (STDs). DNA was extracted from the swabs and nested PCR was performed to amplify the variable domain (VD) 1 - 3 of omp1 gene of Ct followed by gene sequencing. The genotypes of Ct were determined based on the amino acid mutation in VD 1 - 2 of omp1 gene. Results Totally, 1208 swabs were collected. Of them, 132 were Ct positive, and 130 positive samples underwent genotyping. Ten ompl genotypes were determined in total, including serotype E (38, 29.23%), D (25, 19.23%), J(24, 18.46%), F(21, 16.15%), G(7, 5.38%), H(5, 3.85%), K(5, 3.85%), B(2, 1.54%), Ja (2, 1.54%), I (1, 0.77%). E, D, J and F were the dominant type of Ct in this region, and amounted to 83% of all the Ct isolates. Mutations were observed within VD 1 and 2 of omp1 gene in serotype D, B and K.Serotypes were undetermined for Ct in 2 patients with mixed infection. Conclusions In Guangzhou region, E,D, F and J are the predominant genotypes of Ct, and amount to 83% of all the Ct isolates. Ct serotype B is also observed in the urethra of males and cervix of females in this region.

AIM: To investigate the distribution and clonal expansion of TCR V? subfamily T cells in patients with acute monoblastic leukemia (M5). METHODS:The CDR3 of TCR V? 24 subfamily genes were amplified in peripheral blood mononuclear cells from 9 cases with M5 using RT-PCR and the PCR products were further labeled with fluorescent and analyzed by genescan technique for the CDR3 size, to evaluate clonality of the detectable TCR V? T cells. RESULTS:Only 1-10 V? subfamily T cells were identified in M5 cases. Genescan analysis showed that oligoclonal (clonal expansion) T cells were found in some V? subfamilies from 8 cases with M5, V? 2 oligoclonal T cells were identified in six cases, whereas V? 7- or V? 9 clonal expansion T cells were detected in the other two cases, respectively. In addition, except V? 2, V? 7 or V? 21 oligoclonal T cells could be detected in two cases, respectively. CONCLUSION:The skew distribution and clonal expansion of TCR V? subfamily T cells could be found in patients with M5. It may be a specific anti-leukemia immune response with which the host T cells were activated by the leukemia-associated-antigen. The clonal expansion T cells were tendentious in V? 2, which may be related to the M5 leukemia cells associated antigen.

Objective To investigate the protective effects on the renal allografts from brain dead (BD) donor rats pretreated with bone marrow mesenchymal stem cells (MSCs).Method Three groups [normal transplant group (G1).BD transplant group (G2),and MSCs pretreated + BD transplant group (G3)] were set up.Male F344 rats served as donors and male Lewis rats as recipients.In G1,kidneys from F344 donor rats were implanted into Lewis recipients.In G2,kidneys from F344 BD donor rats were engrafted into Lewis recipients.In G3,after BD was established in F344 rats,MSCs were given intravenously to the rats.The kidneys harvested 6 h later were transplanted to Lewis recipients.Cyclosporine was intromuscularly given daily to the recipient rats for 10 days.Right kidneys were resected from recipients on day 10.Creatinine level was examined on day 14,21,28,and 35.Renal allografts harvested on day 35 were pathologically detected.The irnmunochemistry expression of interleukin (IL)-1β and tumor necrotic factor (TNF)-α in renal allograft tissue was tested.Result Serum creatinine levels in G2 were remarkably higher than those in G1 and G3 (P＜0.01) on day 14,21,28,and 35 postoperatively.The creatinine levels on the above mentioned time points had no statistically significant difference between G3 and G1 except on day 21.Postoperative pathological changes in G2 of both pronounced infiltration of mononuclear cells and tubular epithelia[inflammation were notably increased in renal allografts as compared with those in G1 and G3.There was no obvious difference between G1 and G3 in infiltrated mononuclear cells and tubular epithelial inflammation.Positive expression levels of both IL-1β and TNF-α in glomerular,tubular and interstitial epithelial cells were statistically enhanced in G2 as compared with those in G1 and G3 (H =7.210,P =0.027),while there was no statistically significant difference in the expression of both IL-1[β and TNF-α between G1 and G3.Conclusion Brain dead donor rats pretreated with bone marrow MSCs might reduce renal allograft injury via decreasing both inflammatory cell infiltration and IL-1β and TNF-α expression.

Objective To explore the impact of healthcare-associated septicemia (HAS)on hospitalization expense as well as length of hospital stay,so as to optimize the allocation of healthcare resources,and provide scientific basis for reducing the economic burden caused by septicemia.Methods Hospitalized patients with confirmed HAS in a tertiary first-class teaching hospital between June 1 ,2012 and May 31 ,2015 were investigated retrospectively,con-trol group was set up in a 1 :1 ratio,hospitalization expense and length of hospital stay between two groups were compared.Results A total of 285 cases and 285 controls were enrolled in the study,the median of hospitalization expense in case group was higher than control group (￥19 718.39 vs ￥9 289.04,P <0.05);the median of length of hospital stay in case group was longer than control group (14.89 days vs 9.22 days,P <0.05).The disease bur-den caused by septicemia in different age groups and departments were different.The improvement rate of case group was lower than control group (76.49% [218/285 ]vs 83.51 % [238/285 ],χ2 = 2.562,P = 0.009 ). Conclusion As the common blood stream infection in hospitalized patients,septicemia not only increased the ex-pense of diagnosis and treatment,but also affected turnover rate of hospital bed.Rapid and effective diagnosis and treatment is significant o prevent and control septicemia.

Objective To study the relationship between the asthenia TCM syndromes in embryonic development stops and the level of zinc, iron, copper, magnesium, phosphorus, calcium in serum, and provide thoughts for assisting reproduction and preventing miscarriage. Methods Totally 100 patients of embryonic development stops were selected randomly (6-10 weeks gestation) to be the investigated group, with other 100 cases of live fetus as the control group. The contents of trace elements in serum were detected with atomic absorption spectrometry. Results The levels of trace elements in embryonic development stops patients were generally lower than the control group. The serum iron in patients with spleen deficiency syndrome, and serum zinc and iron in patients with kidney deficiency syndrome were significant lower (P<0.05). Conclusion The contents of trace elements in serum have relationships with asthenia TCM syndromes in embryonic development stops. It should be paid attention to supplementing trace elements during the gestation period. For patients with deficiency of kidney and spleen, the supplement of zinc and iron should be given greater prominence.

BACKGROUND:Silk fibroin, as a kind of high-performance biomaterial, has been widely used to construct scaffolds in bone tissue engineering. However, whether silk fibroin itself holds osteoinductive ability has not been reported yet. OBJECTIVE:To investigate the impact of different concentrations of silk fibroin solution on the proliferation and differentiation of rat bone marrow mesenchymal stem cel s (BMSCs) in vitro. METHODS:Silk fibroin and BMSCs were respectively isolated from silkworm cocoon and rat tibia, and were identified. Then, BMSCs were cultured in different concentrations of silk fibroin solution (0.01%, 0.05%and 0.1%), and the cell proliferation and the alkaline phosphatase activity were detected at different time points. RESULTS AND CONCLUSION:FTIR spectra of the sample extracted from silkworm cocoon showed distinct absorption peaks at 1 653 (amide I), 1 530.5 (amide II) and 1 212.3 cm-1 (amide III), which could be confirmed to be silk fibroin. Thus generated BMSCs showed long fusiform or astral morphology, positive for representative markers (CD29, CD44 and CD90) relating to mesenchymal stem cells, and could differentiate into osteocytes, chondrocytes and adipocytes under specific induction conditions, which further confirmed the extracted cells were BMSCs. Compared with the control group (without silk fibroin), 0.05% silk fibroin not only significantly promoted the cell adhesion, migration and proliferation, but also enhanced the alkaline phosphatase activity (P<0.01). With the increasing of the silk fibroin concentrations, the osteodifferentiation capacity of the BMSCs was progressively improved within the range of 0-0.05%and then declined at 0.01%of silk fibroin solutions. These results suggest that silk fibroin can promote osteogenesis, thus providing scientific evidence for developing silk fibroin-based tissue-engineered scaffolds.

Objective To evaluate the therapeutic effect of nurse-led clinics ( NLCs) in patients with type 2 diabetes mellitus ( T2DM) . Methods We searched randomized controlled trials ( RCTs) related to the therapeutic effect of patients with T2DM in PubMed, EMBASE, CENTRAL, Web of science, CBM, CNKI, VIP, and Wanfang databases from the beginning to June 2016. The methodological quality assessment was used to assess the included studies according to “bias risk assessment” recommended by Cochrane Handbook 5. 1. 0 software, and the data were extracted and analyzed by using the RevMan 5.1 software. Results Totally 15 RCTs with 2 204 patients were included in this study. The Meta-analysis showed that:compared with the control group, NLC intervention can further decrease the HbA1c level of patients with T2DM [ MD=-1.11, 95%CI(-1.47,-0.75), P<0.001];improve patients′adherence to medication [RR=1.28, 95%CI(1.20,1.35)], diet control [RR=1.68, 95%CI(1.52,1.86)], exercise reinforcement [RR=1.32, 95%CI(1.22,1.43)], and regular blood glucose monitoring [ RR=1. 68, 95%CI ( 1. 30, 2. 17 ) ]; and improve patients′ quality of life. Meta-regression analysis showed that the effect of NLC were positively related to the baseline level of HbA1c ( r=-0.33, P<0.05). Conclusions The application of NLC can improve the therapeutic effect of patients with T2DM, and improve their treatment compliance and quality of life.

Objective To develop Chinese version of the Manchester patient safety framework, and evaluate the feasibility of its clinical application. Methods The Manchester patient safety framework (MaPSaF) was transformed into Chinese version by translation and back-translation together with inquiries from experts. The trial study was done firstly among 136 nurses in five pilot wards and followed by five times of focus-oriented group interviews. A semi-structured, in-depth interview was then performed in 12 randomly selected participants and acquired data were analyzed by category analysis. Result Two themes were abstracted: Chinese version of MaPSaF showed a good practicability, effectiveness and operability and it was effective for deepened understanding of patient′s safety culture. Conclusion The Chinese version of MaPSaF can be used for safety culture evaluation during nursing process in China.

Objective To investigate the risk factors for acute radiation esophagitis andpneumonitis after radiation therapy in esophageal cancer (EC) patients with diabetes or hypertension.Methods A total of 373 EC patients receiving three dimensional conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) were included in this study.Among these patients,42 showed concurrent with diabetes and 99 with hypertension.Radiation esophagitis or pneumonitis in patients with or without diabetes,and with or without hypertension were monitored in the 1-year follow up,respectively.Results The prevalence of grade 1,2,3 and 4 radiation esophagitis in diabetes and non-diabetes patients was 40.5％,38.1％,14.3％,4.8％ and 66.2％,27.8％,2.7％,1.8％,respectively,while that of the grade 1,2 and 3 radiation pneumonitis in diabetes and non-diabetes patients was 31.0％,16.7％,9.5％ and 30.8％,15.7％,1.2％,respectively.The prevalence of grade 3 or above radiation esophagitis and pneumonitis in patients with diabetes and was significantly higher than those with non-diabetes (x2 =13.573,12.279,P ＜ 0.05).The prevalence of grade 1,2,3 and 4 radiation esophagitis in hypertension and non-hypertension patients was 49.5％,38.4％,8.1％,3.0％ and 68.2％,25.5％,2.6％,1.8％,respectively,while that of the grade 1,2 and 3 radiation pneumonitis in hypertension and non-hypertension patients were 30.3％,18.2％,5.1％ and 31.0％,15.0％,1.1％,respectively.The prevalence of grade 3 or above radiation esophagitis and pneumonitis in patients with hypertension was significantly higher than those with non-hypertension (x2 =5.695、5.422,P ＜ 0.05).Diabetes is an independent risk factor for grade 3 or above acute radiation esophagitis and pneumonitis.Conclusions Diabetes or hypertension might be risk factors for severe radiation esophagitis and pneumonitis in EC patients receiving radiation therapy.