Objective To identify the influencing factors for pediatric nursese' reporting of adverse events at 3A hospitals in Beijing. Methods Adopting the random sampling of ten 3A hospitals with pediatric wards in Beijing and conducting an questionnaire survey of some nurses in those hospitals. Results The possibility of adverse events reporting increased with the awareness of adverse events which was related with their severity. Except for title, educational background, length of service, position and past experiences were not associated with the barriers. The major perceived barrier was fear of colleague relationship brokenup and some other undesirable consequence. Conclusions Better training of awareness of adverse events and changes of the punitive culture by the roots as well as some regulation or policy were the major solutions to improve incident reporting.

Objective To explore the clinical value of using heparin in DIC caused by Tsutsugamushi.Methods 27 cases of Tsutsugamushi with DIC were divided into two groups. The heparin treatment group(n = 15) and non-heparin treatment group(n = 12). The two groups were compared and analyzed. All the cases were diagnosed definitely depended on the "Tsutsugamushi-Disease-Diagnosis Standard".Results The group which use heparin improved in rectifying shock,terminating heorrhage,restoring the time of lab index of DIC,rating of MOF and death. Compared with the control group, the difference had statistical significance(P

Desmoid tumor of abdominal wall was also known as fibronmatosis of abdominal wall.It is a rare benign fibroblastic tumor, which is characterized by non-enveloped,strong local infiltration, with high recurrence rate after surgery.In December 2011, one patient with huge desmoid tumor of abdominal wall with intestinal tube received surgical resection with single-stage patch repair for the large defect in abdominal wall at the 210th Hospital of PLA, and the result was satisfactory.

Objective:To analyze the report accuracy and risk factors of congenital syphilis (CS), and to provide references of accurate diagnosis for clinicians.Methods:CS notification data, including suspected cases and confirmed cases, were obtained from national notifiable disease reporting system (NNDRS) reported from 2016 to 2019 in Guangzhou City. Information of syphilis infected pregnant women and their children who were diagnosed or excluded with CS during 2012-2019 were extracted from Guangzhou City'the integrated prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus surveillance system’. Their demographic characteristics, serological test results of syphilis, reporting doctors and treatment regimens were analyzed.Chi-square test was used for univariate analysis and multivariate logistic regression analysis was used to identify the influencing factors associated with CS.Results:A total of 95 CS cases were reported in NNDRS, and the reporting accuracy rate was 36.8%(35 cases). The proportion of children younger than 30 days who were reported incorrectly (73.3%(44/60)) was higher than the proportion of those were reported correctly (51.4%(18/35)), and the difference was statistically significant ( χ2=4.679, P=0.031). However, the reporting accuracy was not associated with hospital grade, doctor profession and doctor title of reporting ( χ2=0.283, 0.483 and 3.681, respectively, all P>0.05). Maternal age≤24 years (adjusted odds ratio ( aOR)=4.62), titers of non- Treponema pallidum antigen serologic test before treatment≥1∶8 ( aOR=7.56), initiation of antisyphilitic treatment during delivery ( aOR=25.43), no antisyphilitic treatment during pregnancy ( aOR=14.12), and premature delivery ( aOR=8.97) increased the risks of CS (all P<0.01). Conclusions:The reporting accuracy rate of CS is low. Young mothers, high serological titers of non- Treponema pallidum antigen before treatment, initiation of antisyphilitic treatment during delivery or no antisyphilitic treatment during pregnancy, and premature delivery are risk factors for CS. Doctors may focus on collecting this information to assist clinical diagnosis.

Objective To investigate the infection status of A ngiostrongylus cantonensis in winkle from 9 cities in Guizhou Province.Methods The winkles were collected randomly from aquatic products wholesale market,agricultural market or restaurants in 9 cities (Guiyang,Zunyi,Tongren,Kaili,Anshun,Duyun,Xingyi,Bijie and Shuicheng) and classified in Guizhou Province,and the third-stage larvas of Angiostrongylus cantonensis were separated and detected with microscopy by tissue homogenization (Pomacea canaliculata was first checked with lung screening method,and then rechecked by tissue homogenization),and infection rate was calculated.Results Totally 2 177 winkles were tested,the overall infection rate of Angiostrongylus cantonensis was 1.5％ (32/2 177),among them,Pomacea canaliculata was 1 287,five was positive,and the infection rate was 0.4％; Achatinafulica was 240,positive 27,the infection rate was 11.3％; Bellamya lithophaga was 372 and all 278 Cipangopaludina chinensis was not positive.Conclusions There is a higher risk of infection with Angiostrongylus cantonensis if eating winkles.The third-stage larva in Pomacea canaliculata and Achatina fulica has been found in Guizhou Province.Market management,food-safety inspection of the winkles on sale,and public health education should be strengthened.

OBJECTIVE: To investigate the usefulness of anterolateral thigh flap for reconstruction of the defect after maxillectomy. METHOD: Seventy-two cases with defect after maxillectomy were constructed with anterolateral thigh flap in our department during 10 years. All cases were undertaken total maxillectomy. RESULT: All flaps except one were transferred successfully. Patients were satisfied with their appearances. No serious complications had happened. CONCLUSION Anterolateral thigh flap could be an donor flap for the reconstruction of the defect after maxillectomy.
Face ; surgery ; Free Tissue Flaps ; Humans ; Maxilla ; surgery ; Reconstructive Surgical Procedures ; Thigh

Objective To compare the clinical efficacy of gemcitabine arterial infusion chemotherapy with intravenous chemotherapy in the management of patients with advanced pancreatic cancer and to evaluate the efficacy and safety of gemcitabine arterial infusion chemotherapy. Methods 43 patients with advanced pancreatic cancer were included in this study, of whom 21 patients received arterial infusion chemotherapy (Group A) and the other 22 were treated by intravenous chemotherapy (Group B), gemcitabine combined with 5-FU chemotherapy was administrated in both groups. The main outcomes were clinical benefit response (CBR), tumor response rate and toxicity. Results Compared with Group B, there was a significant improvement of CBR in group A (81% vs 50%, P =0.033) ; there was also significant improvement of pain control in group A (76.2% vs 45.5%, P =0.039). There was no significant difference in the tumor response rate between two groups (33.3% vs 22.7%, P =0.498). No significant increase of side effects was observed in both groups. Conclusions In the management of advanced pancreatic cancer, the arterial infusion method may be more favorable than intravenous approach in improving clinical benefits with mild toxicity and well tolerability.

Objective To investigate the expression of TLR2 and HIF-1α in pancreatic cancer and explore the relationship between TLR2 or HIF-1α protein and the clinical or pathological changes in pancreatic cancer. Methods The mRNA of TLR2 and HIF-1α in 30 cases of pancreatic cancer and its adjacent tissues were detected with real-time PCR and with immunohistochemical methods in 65 cases of pancreatic cancer and 38 cases of corresponding adjacent tissues. The relationship between TLR2 or HIF-1α and pathologic features of pancreatic cancer was analyzed. The correlation between TLR2 and HIF-1α in pancreatic cancer was also assessed. Kaplan-Meier method was used to assess the impact of TLR2 or HIF1αexpression on survival. Results The relative quantification of TLR2 mRNA and HIF-1α mRNA in pancreatic cancer tissues was 0.84±0.17 and 0.87±0.11, respectively, which was significantly higher than that in adjacent tissues 0.70±0.13 and 0.68±0.13 respectively,P＜0.05. The protein expression of TLR2 and HIF-1α in pancreatic cancer tissues was 63. 10% and 70.8%, respectively, significantly higher than that in adjacent tissues (34.20% and 36.8%, respectively). There was no significant correlation between the expression of TLR2 or HIF-1α protein and the age, gender, tumor location, the degree of differentiation in patients with pancreatic cancer (P＞0.05). However, there was significant correlation between the expression of TLR2 or HIF-1α protein and tumor size, lymph node metastasis, venous invasion and clinical staging. TLR2 and HIF-1α had a significant impact on survival. Conclusion TLR2 and HIF-1α overexpressed in pancreatic cancer and TLR2 signaling pathway may promote development of the pancreatic cancer with HIF-1α together.

Objective To investigate the short and long term therapeutic effects of prostaglandin E1 (PGEl) on diabetic nephropathy (DN). Methods Patients with DN in stage Ⅲ to Ⅴ according to Mogensen criteria were randomly assigned to four groups of PGE1, angiotensin-converting enzyme inhibitor (ACEI), PGE1 + ACEI and control drug. The levels of proteinuria and albuminuria were measured before and 15 days, 6 months and 18 months after treatment. Patients with DN in stage Ⅳ were subdivided into three groups according to proteinuria: early stage IV (protienuria was less than 1.5 g/d), middle stage Ⅳ (protienuria was between 1.5 g/d and 2.5 g/d) and late stage Ⅳ (protienuria was larger than 2.5 g/d). Results Fifteen days after treatment, the levels of proteinuria and albuminuria were significantly decreased compared with pre-treatment in PGE1 and PGE1 + ACEI groups (P<0. 01), and the therapeutic effect was better in PGE1 + ACE1 group than in ACEI group (P<0. 01). Six months after treatment, there were still significant differences in above parameters in patients with DN in stage Ⅲ and Ⅳ between PGE1 + ACEI and PGE1 groups. And for the patients in stage Ⅴ, statistic significance between pre-and post-treatment existed only in PGE1 + ACEI group (P<0. 05). but not in PGE1 and ACEI groups (both P>0. 05). Eighteen months atter treatment, the levels of proteinuria and albuminuria were significantly decreased in patients in stage HI and early stage IV in all treatment groups (P<0. 01). For patients in middle stage IV and late stage Ⅳ , the significant differences still occurred between pre-and post-treatment in PGE1 + ACEI group (P<0. 01 or P<0. 05), and were significantly better than in ACEI group (P<0. 01 or P<0. 05). However, the proteinuria of patients in late stage IV elevated in PGE1 group in post-treatment versus pre-treatment (P<0. 05). Conclusions The short term therapeutic effect of PGE1 is quick and good in patients with DN. The therapeutic effect is much better in patients in stage Ⅲ compared with stage Ⅴ. The combination of PGE1 and ACEI will get better best therapeutic effect than PGE1 or ACEI alone in long term.

BACKGROUND: The expression of Fas antigen and P53 protein in colorectal cancer could reflect the biological character and the prognosis of the tumor.OBJECTIVE: To investigate the relationship between the expression of Fas antigen and P53 protein in coloreetal cancer and the tumor-related biological characters.DESIGN: A controlled experiment by introducing pathological specimens as subjects.SETTING: The study was conducted in the Department of Pathology of Xijing Hospital Affiliated with the Fourth Military Medical University of Chinese PLA.PARTICIPANT S: Totally 32 pathological specimens of colorectal cancer were randomly selected from the Department of Surgery of Xijing Hospital between January 1995 and October 1998. Sixteen normal large intestine tissues were selected form the cadaver of pathology department.METHODS: The expression of Fas antigen and P53 protein in 32 colorectal cancer tissue and 16 normal intestine tissue were tested and compared with immunohistochemical method.MAIN OUTCOME MEASURES: Fas antigen and P53 protein expression in coloreetal cancer and normal intestine, and the clinical indicators of patients with colorectal cancer.RESULTS: The expression of Fas antigen was positive in normal large intestine tissue while the expression of P53 protein was negative. The positive rate of Fas antigen expression in colorectal cancer was 41% (13/32), while the positive rate of P53 expression in colorectal caner was 53% (17/32). Fas antigen significantly decreased in colorectal cancer tissues. The expression of Fas antigen was correlated with the histological type of colorectal cancer and its liver metastasis( P ＜ 0.05) . And the expression of P53 protein was correlated with the liver metastasis of colorectal cancer( P ＜ 0. 05).CONCLUSION: The expression of Fas antigen significantly decreases in colorectal cancer. The higher the malignance is, the more significant less the expression is. Fas antigen does not express in liver metastasis patients. P53protein had positive expression in colorectal cancer tissues, especially in patients with liver metastasis. The reduction and deletion of Fas antigen expression and the excessive expression of P53 protein indicate poor prognosis.