Cluster Analysis ; Fuzzy Logic ; Humans ; Mathematics ; Medicine, Chinese Traditional

This study was aimed to explore effects of Zi-He-Che (ZHC) on estradiol (E2), follicle stimulating hor-mone (FSH), luteinizing hormone (LH) among perimenopausal rat model. The 4-month-old young female SD rats with vaginal smear of normal estrous cycle and 18-month-old aged female SD rats with vaginal smear of no estrous cycle were selected as the normal control group. The 11- and 12-month-old female SD menopausal rats with vaginal smear of estrous cycle disorder were selected and randomly divided into the model group, treatment group and posi-tive control group. The normal control group and the model group were given physiological saline. And the treatment group was given ZHC. The positive control group was given prescription from the textbook. Observation was given on effects of ZHC on E2, LH and FSH among perimenopausal rat model. The results showed that compared with the young group, the level of E2 in the old and model group was significantly decreased (P<0.01), the level of FSH and LH were significantly increased (P<0.01). Compared with the model group, the level of E2 in the treatment group and positive control group was significantly increased (P<0.01), the level of FSH and LH were significantly decreased (P<0.01). It was concluded that both ZHC and prescription from the textbook were able to reduce FSH and LH levels, and increase the estrogen level among perimenopausal rats.

Objective To investigate healthcare-associated infection(HAI)in patients in a cancer hospital,provide reference for controlling HAI in cancer patients,and guide rational use of antimicrobial agents.Methods Clinical data of patients in a cancer hospital between August 2006 and July 2012 were analyzed retrospectively.Results The incidence of HAI case was 1 .53% (2 060/134 389),and annual incidence showed a downward trend.The main in-fection site was lower respiratory tract (46.46%,n=957),followed by bloodstream (15.63%,n=322),abdominal and pelvic (14.03%,n=289).The main pathogens were Pseudomonas aeruginosa (16.16%,n=350),Staphylo-coccus aureus (9.97%,n=216),Klebsiella pneumoniae (9.79%,n=212),Escherichia coli (9.65%,n=209), and Candida albicans (6.51 %,n=141 ).Gram-negative bacilli,including Klebsiella pneumoniae and Escherichia coli ,were sensitive to carbapenems and β-lactamase inhibitors.Conclusion Lower respiratory tract is the major HAI site in patients with cancer,and gram-negative bacteria are the main pathogens.Carbapenems andβ-lactamase inhibitors are recommended for the empirical treatment of HAI in cancer patients.

A 29-year-old woman was admitted to the Department of Rheumatology,Peking Union Medical College Hospital due to intermittent rashes,fever and headache.Palpable purpura were symmetrically distributed on the extremities and trunk.Other manifestations included headache with nausea and vomiting.Elevated white blood cell (WBC) count,platelet (PLT) count,erythrocyte sedimentation rate (ESR) and C-reactive protein were the main laboratory findings.Antinuclear antibodies and antineutrophil cytoplasmic antibodies were negative.Examination of the cerebrospinal fluid (CSF) revealed high intracranial pressure,while routine cytology and biochemical tests of CSF were normal.Head MRI scan and PET-CT did not detect remarkable findings.A diagnosis of systemic vasculitis was confirmed by the biopsy of skin lesion which showed inflammatory infiltration of the muscular vessel wall.Combination therapy of corticosteroids and cyclophosphamide lead to a rapid improvement in clinical symptoms and laboratory parameters.The patient was in stable remission till 6 month follow-up.

Objective To construct a fusion protein that used for treatment of resistance and palindromia in leukemia and studied its biological activity. Methods IL-3 and LP gene fragments were amplified by PCR. After enzymatic digestion and T4 ligation, the fusion gene was cloned into expression vector pAYZ. The product was purified by exchange chromatography and anti-Etag affinity chromatography. IL3-G4SLP fusion protein was analyzed by SDS-PAGE and Western blot. Protein biological activity was detected by FACS. Results The fusion protein was expressed as soluble protein by E.Coli 16C9. The protein expression level was about 1 mg/L, its purity was over 95 %, and the expression level was about 1 mg/L. The fusion protein can combined specificely with CD123 on leukemia stem cells. Conclusion Fusion protein IL-3-G4S-LP can target on leukemia stem cells and maybe as a potential drug used for treatment of resistance and palindromia in leukemia.

Objective To retrospectively analyze and conclude the characteristics of imaging appearances of solid psedopapillary tumor of pancreas.Methods Among 7 cases with pathologically proved solid psedopapillary tumor of pancreas,6 cases underwent CT examinations of upper abdomen preoperatively,and the rest One had MRI examination.The mean age of these 7 cases(all female)was 30.7 years(range,14—44 years).Results The tumors were usually quite large in the largest diameter ranged from 2.8 to 15.9cm(mean largest diameter,7.9 cm);Tumors were all well demarcated,and 5 of them were of capsule on CT or MR imaging.All tumors were well-encapsulated on pathologic specimens, except for the capsule of 1 tumor was partially invaded;In 6 cases underwent CT examination,scattered, punctate and linear calcification were noted in the capsule of 2 tumors and the rim of another one;Except for 1 tumor was almost solid,the other 6 tumors contained both solid and cystic components;Scattered sheets of high attenuation shown in the cystic or solid parts on CT imaging in several cases and the high signal intensity on T_1-weighted MR imaging signified the possibility of bleeding in tumors,which then was testified by pathologic evaluation.Conclusion The solid psedopapillary tumor of pancreas has comparatively characteristic clinical and imaging features.

ObjectiveTo analyze the relationship between pancreatic cancer (PC) and diabetes mellitus (DM),and the clinical and pathological features of pancreatic cancer in patients with DM.MethodsFrom January,2008 to December,2010,151 patients with PC and 195 comparable patients without PC were enrolled in a case-control study to analyze the relationship between PC and DM.ResultsThe OR was 5.91 (95％ CI 3.03-8.00,P＜0.05) in PC patients with DM for less than 2 years,and 1.308 (95％ CI 0.37-4.60,P＞0.05) in patients with DM for 2 to 5 years,and 1.16(95％ CI 0.44-3.19,P＞0.05) for patients with DM for more than 5 years.There was no significant difference between PC patients with and without DM in gender,age,body-mass index (BMD,obstructive jaundice,tumour location and tumour metastases (P＞0.05).ConclusionsThere was a significant correlation between PC and DM.De novo DM may be a clinical manifestation in patients with PC.PC patients with concurrent DM have no particular clinical and pathological features.

Objective To analyze the clinical effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) in combination with unilateral pedicle fixation on lumbar degenerative diseases in the elderly.Methods From June 2011 and June 2013,51 elderly patients with lumbar degenerative diseases who underwent MI-TLIF in combination with unilateral pedicle fixation,including 39 males and 12 females,aged from 60 to 72 years (average 65 years old),were included in this study.All the 51 cases had mono segmental lesion,including 11 cases with the lesion in L3.4,22 cases with the lesion in L4.5,and 18 cases with the lesion in L5-S1.The operation time,blood loss,postoperative drainage and complications were recorded.Postoperative outpatient follow-ups were conducted once every 2-3 months for all cases,and JOA scoring criteria (29 points) of lower back pain were adopted to evaluate the clinical effects.Thin-layer helical CT scanning reconstruction was applied to evaluate the fusion rate of bone grafting.X-ray film of lumbar vertebra AP & LAT was employed to evaluate the intervertebral space height,the internal fixation and the position of cage.Results The operation time ranged between 50-90 min with a mean value of 65 min; blood loss ranged between 80-180 ml (average 110 ml); and postoperative drainage volume ranged between 20-70 ml (average 40 ml).Healing phase I was achieved in 49 cases,while post-operative local cutaneous necrosis around the incision site occurred in 2 case and the wound healed well after wound dressing.Dural laceration without nerve root injury occurred in 2 cases.The follow up in 51 patients ranged between 18 24 months (average 20 months).In terms of JOA scoring,the preoperative score was (9.7± 1.6),the post operative score was (21.4 ± 1.4) 7 d after operation and the score was (25.4 ± 1.2) in the final follow up.During the final follow-up,35 cases were evaluated as excellent,11 cases as good and 5 cases as moderate,the excellent and good rate was 90.2％,and the fusion rate of bone grafting was 88.2％.The intervertebral space height ranged from (9.2±1.5) mm before operation to (11.2±1.3) rnm 7 d after operation,to (11.0±1.2) mm in the final follow-up.There were significant difference in intervertebral space height before and after operation (both P＜0.05),and no difference was found between 7d after operation and the final follow-up (P＞0.05).Looseness,fracture or cage displacement were not observed.Conclusions The clinical effect of MI-TLIF in combination with unilateral pedicle fixation on lumbar degenerative diseases in the elderly is satisfied.It has the advantages of high fusion rate,less trauma,quicker recoverer,higher cost effectiveness and convenience.However,the indications for operation should be restricted and the long-term curative effect remains to be studied in further clinical studies.

Objective To explore the feasibility and effectiveness of channel-assisted spatium intermusculare approach interbody fusion for treating lumbar vertebra diseases.Methods A total of 81 patients with lumbar vertebra diseases were treated from June 2012 to December 2013,including 35 males and 46 females between 29 and 76 years old with an average age of 54.6.There were 36 cases of lumbar disc degeneration,10 cases of recurrence in situ after lumbar disc herniation surgery,6 cases of huge lumbar disc herniation,11 cases of lumbar disc herniation with spinal canal stenosis,5 cases of extreme lateral lumbar disc herniation and 13 cases of lumbar degenerative spondylolisthesis.There were 67 cases of single segment lesion and 14 cases of two segment lesions.Lesion sites contained L1,2 in 1 case,L3,4 in 4 cases,L4,5 in 50 cases,L5S1 in 12 cases,L3,4 and L4,5 in 8 cases,and L4,5 and L5S1 in 6 cases.Results The length of incision was 2.42±0.45 cm in cases of single segment lesion and 4.28±0.38 cm in cases of two segment lesions.The operation time was 96.00±21.53 minutes and intraoperative blood loss was 347.50± 241.62 ml.During the operation,one case suffered from dural laceration,cerebrospinal fluid leakage and ipsilateral nerve root injury.Two cases suffered from pedicle fractures.Eight cases experienced epidermal necrosis of the incision.One case had poor wound healing.Three cases suffered from nerve injury.A total of 76 patients were followed up for 12-30 months,averagely 20.5 months.Intervertebral height of lesion segments was apparently recovered after surgery,and maintained in good condition during the final follow-up.No significant difference in the changes of area and grade of multifidus was detected 12 months after surgery and before surgery.Except 4 cases,the remaining had interbody fusion with a fusion rate of 94.7％.The balance between the coronal plane and sagittal plane of the lumbar spine was evidently improved.Average Japanese Orthopaedic Association score increased from 12.66±1.88 points preoperatively to 26.4±1.92 points during the final follow-up,which showed significant differences.Conclusion The method of channel-assisted spatium intermusculare approach interbody fusion has some advantages for treating lumbar vertebra such as small incision,fewer traumas,less bleeding,fast recovery,and high fusion rate.However,there is a long time of operation in the early stage and high occurrence rate of complications.

Objective Aliginic sodium diester(ASD) liposome was prepared and its aggregation stability was evaluated.Methods ASD liposome was made by reverse phase evaporating method from egg yolk lecithin,compared with blank liposome,the size distributions and mean particle diameters of ASD liposome and blank liposome were measured respectively before and after 40 hours heating under 37℃.Results Under the condition of n(PC)∶n(CHOL) = 1∶1,the mean size diameter of ASD liposome was 4.24?m.The mean size diameter of ASD liposome changed only 0.26?m after cultivation,however,the value of blank liposome was 1.35?m.Conclusion ASD loaded in the liposome enhanced the physical stability of the liposome.