Maternity insurance is a policy support of China for women of child-bearing age.Given its good outcomes since it is enforced clinically,such insurance has been confronted with challenges as well.Doctors and nurses of Ob/Gyn departments serve as both protectors of parturient women's interests and practioners of the economic and social interests of the hospital.This paper summarized the experiences of maternity insurance of the Ob/Gyn department of the hiospital in rencent 6 years.The hospital has had 2026 inpationts covered by maternity insurance,without any medical disputes and harvesting a cash surplus of 657145 yuan.Such doctors and nurses are found to play a key role in ensuring a good doctor-patient relationship,and serve as clinival references for the single-disease management and teaching of the hospital.

Objective Based on dual channel melting curve analysis-based assay,we developed a method to rapidly detect the drug-resistant mutations in Mycobacterium tuberculosis through real-time PCR.Methods According to the common first-line drug-resistant mutations of Mycobacterium tuberculosis,we designed six dual-labeled fluorescence probes to rapidly detect the drug-resistant mutations through realtime PCR melting curve after amplifications of drug-resistant related gene region of DNA.The targets include rpoB 81 bp core region,katG315,inhA promoter,ahpC promoter and embB306.To validate the sensitivity and specificity of our method,we performed real-time PCR assays to detect drug-resistant mutations in 76 clinical MDR-TB samples,which were collected by Shanghai CDC in 2008.Results In the validation,this method successfully detected drug-resistant mutations in all 76 clinical MDR-TB samples.The △Tm of mutations were from 1.8 to 14.4 ℃.Comparing with the sequencing data,all mutations covered by the six probes were detected with 100％ sensitivity and 100％ specificity (rpoB,80/80; inhA,7/7 ; katG315,59/ 59;ahpC,8/8;embB306,27/27).This method can successfully detect drug-resistant mutations from 100 copies/μl DNA samples.Conclusions A widely applicable real-time PCR assay to detect first line drug-resistant mutations of Mycobacterium tuberculosis has benn developed.This method has proven to have the advantages of high sensitivity,specificity and low risk of contamination.It can be used in rapid diagnosis of clinical drug-resistant tuberculosis and the evaluation of laboratory drug sensitivity test.

Objective To investigate the effects of posterior fossa operation analgesia with tramadol compound dexmedetomi‐dine ,and the feasibility of reducing the dosage of tramadol .Methods Forty cases undergoing posterior fossa operation were ran‐domly divided into dexmedetomidine group (group A) and control group (group B) .Patients in group A with tramadol compound dexmedetomidine intravenous infusion analgesia ,reducing the dosage of tramadol .Group B with tramadol intravenous infusion anal‐gesia .To observe two groups of patients with preoperative ,postoperative 1 ,6 ,12 ,24 ,48 hVAS score ,Ramsay score ,heart rate , blood pressure ,respiratory rate ,SpO2 ,the postoperative complications such as nausea and vomiting ,and carries on statistics analy‐sis ,the two groups of patients with postoperative analgesic and sedative effect evaluation .Results VAS score :postoperative at each time point ,there was no significant difference between groups (P>0 .05) .Ramsay score :after operation and postoperative at each time point ,the experimental group were significantly higher than those in the control group (P<0 .05);the incidence of nausea and vomiting ,restlessness complications ,the experimental group was significantly lower than that of the control group (P<0 .05) .Con‐clusion Posterior fossa operation patients with tramadol and dexmedetomidine postoperative to analgesia could reduce the dosage of tramadol ,reduce nausea and vomiting ,restlessness and other complications ,and the analgesic effect is ideal .It was favorable to ob‐serve the postoperative condition .

Coronary Angiography ; adverse effects ; Heart Atria ; Humans ; Male ; Middle Aged

Background and purpose:Drug-resistance is the main obstacle in terms of efficacy of chemotherapy for leukemia, RNA interference(RNAi) strategy possesses the characteristics of specilization, high-efficiency and low-toxicity, and can effectively and specifically inhibit the overexpression of given gene. This study was designed to investigate the effect of small interfering RNA (siRNA) on expression of mdr1 gene and drug-resistance in multidrug-resistant human leukemia K562/ADM cell.Methods:Human multidrug-resistant leukemia cell line K562/ADM over-expressing mdr1 gene was used as the target cells, Two siRNAs (si-mdr1-1 and si-mdr1-2) targeted mdr1 gene were chemically synthesized and transfected into K562/ADM cells. Expression of mdr1 mRNA was determined by RT-PCR, P-glycoprotein (P-gp) expression was measured using flow cytometry (FCM), and the sensitivity of K562/ADM cells to adriamycin was assessed with a MTT colorimetric assay.Results:Two siRNAs (si-mdr1-1 and si-mdr1-2) specially designed in this study could markedly down-regulate the expression of mdr1 mRNA and its product P-gp in K562/ADM cells. After cells transfected with si-mdr1-1 or si-mdr1-2 for 24h and 48h, the inhibition of mdr1 mRNA expression in the cells for si-mdr1-1 was 55.5% and 22.5%; and for si-mdr1-2, 16.0% and 57.6%, respectively. Treated with siRNA for 72h, the expression intensity of P-gp in the two transfected cell lines decreased 74% and 85%, respectively. Both si-mdr1-1 and si-mdr1-2 significantly enhanced the sensitivity of K562/ADM cells to adriamycin and reversed their drug-resistance, the reversal efficiency was 2.52-folds and 1.96-folds, respectively.Conclusions:The siRNA could effectively and specifically silence the expression of mdr1 gene and overcome the drug-resistance mediated by P-gp in K562/ADM cells.

An immunopotentiating compound has been isolated from the metabolites of Bacillus mycoides under the bioassay-guided isolation and identification for its immunopotentiating effect and chemical structure. The isolation and purification of the compound were consisted of macroporous adsorptive resins, silicagel chromatographic column and Sephadex G-200 chromatographic column. The immunopotentiating effect was assayed in every step isolation. At last, the only substance having the strongest immunopotentiating effect had been isolated and purified. Through the procedure consisiting of Ultra-Violet spectroscopy (UV), IR (Infrared Radiation), Time of Flight Mass Spectrum (TOF-MS), Nuclear Magnetic Resonance (NMR) and Element analysis, the possible structure of compound M had been identified as cyclic (Pro-Gly) dipeptide (C7H10O2N2) (Diketopiperazine). To be determined the immunopotentiating effect, the mice were treated by intraperitoneal injection of cyclic (Pro-Gly) dipeptide in the treatment group and physiologic saline in the control group. At the 14th day after the injection, the SOD activity and the phagocytosis activities reached the peak value and were significantly higher than those in control group. At the 21st day, the bactericidal activity reached peak value and was significantly higher than that in the control group. From the above results, we concluded that the main active component enhancing the immunity of mice was cyclic (Pro-Gly) dipeptide in the metabolism of Bacillus mycoides.

In recent years, with the development of sequencing technology and research on molecular changes in different races of prostate cancer, it has been found that the pathogenesis of prostate cancer showed obvious ethnic differences. This article reviewed the research progress of ETS fusion genes, FOXA1, SPOP, IDH1 and other driver genes in prostate cancer. And the research of molecular typing of prostate cancer showed different patterns of molecular changes in Chinese and western populations. The molecular changes of prostate cancer in western populations were dominated by ETS fusion gene, while those in Chinese populations were dominated by gene mutations, mainly FOXA1 and SPOP mutations. Moreover, the dominant fusion gene in Chinese prostate cancer was not ETS fusion gene, but SCHLAP1-UBE2E3.

OBJECTIVE: To discuss the clinical characteristics, imaging findings, surgical treatment and effectiveness of faciocervical lipomas in children. METHOD: Twenty children with lipomas who were performed surgical resection under the tracheal intubation anesthesia, of which 3 cases located in face and 17 cases located in neck were retrospectively analyzed. Computed tomography (CT) was used in 8 cases and magnetic resonance imaging (MRI) in 6 cases for differential diagnosis. CT and MRI were used to diagnose 6 patients pre-operatively. RESULT: The image of computed tomography (CT) revealed that 15 cases showed oval and flat circular area and 5 cases showed lobulated lesion. The CT value was negative typically. The signal was inhomogeneous in MRI. The patients' magnetic resonance imaging (MRI) presented a high signal intensity on T1 and T2WI. The hyperintense signal can be suppressed in fat-suppression T2WI sequence. The hypointense of tumor signals fell in tandem surrounding adipose tissue. All the patients got satisfied curative effect after operation. There were no complications such as trachyphonia, bucking and dyspnea. Following up for 6 months to 2 years,no recurrence case occurred. CONCLUSION Lipomas generally occur in adult patients, quite rare in children. Imaging examination is helpful in the differential diagnosis of lipoma. Surgical resection is the only effective treatment for lipomas at present.
Adult ; Child ; Diagnosis, Differential ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Lipoma ; diagnosis ; surgery ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To assess the effectiveness of the combined treatment model for Wilms'tumor and to improve treatment results.Methods Fifty-five patients diagnosed with Wilms' tumor between July 1981 to June 2010 were analyzed retrospectively.Eighteen patients were diagnosed by preoperative ultrasound-guided fine needle biopsy,and 53 patients were confirmed by postoperative pathology results.Seven cases were in clinical stage Ⅰ,19 cases in clinical stage Ⅱ,21 cases in stage Ⅲ,six cases in stage Ⅳ and two cases in stage Ⅴ.Thirty-five cases had histopathological subtype,30 cases had the favorable type,and five cases had the unfavorable type.Among the 55 patients,kidney tumor resection was performed on 48 cases,wide edge partial nephrectomy was performed on two cases,tumor enucleation was performed on one bilateral renal tumor case,kidney tumor resection with pulmonary metastasectomy was performed on two cases,and two cases had no surgical procedures.Eighteen cases received preoperative chemotherapy,40 cases received postoperative chemotherapy,and 12 cases received postoperative radiotherapy.Patients were grouped according to age,stage,histological type,treatment model,treatment course and whether or not they had radiotherapy.The Kaplan-Meier method was used in the evaluation and comparison of over survival (OS),disease free survival (DFS) and relapse free survival (RFS) of the different groups to reveal the relationship between different grouping factors with the prognosis of Wilms' tumor. ResultsThe median of follow-up was 34 mon ( ranging from 3 to 355 mon).The 3-year OS,5-year OS and 2-year DFS were 77.6％,69.0％ and 52.4％,respectively.The differences of OS in different stages ( P =0.006 ),DFS between pure operation group and combined therapy group ( P =0.004 ) and RFS between radiotherapy group and no radiotherapy group ( P =0.03 ) were significant,P ＜ 0.05.ConclusionsThe normative multi-disciplinary treatment model for patients with Wilms' tumor can achieve good results and is well tolerated.

Objective To investigate the mechanism of the soluble A? oligomers-induced alteration of synaptic proteins. Methods This study applied immunocytochemistry technique to investigate the changes of the expression of postsynaptic density-95(PSD-95) in primary hippocampal neurons, which was exposed to A?_ 25-35 after NMDAR antagonist or agonist treatment. Results The results showed that A?_ 25-35 downregulated PSD-95 protein in a dose- and time-dependent manner. Treatment of cells with MK801 (a general NMDA receptor antagonist) prevented A?-induced PSD-95 degradation. Moreover, when extrasynaptic NMDA receptors were blocked by ifenprodil (a NR2B subunit specific antagonist), the A?-induced downregulation of PSD-95 was significantly attenuated. Whereas, when synaptic NMDA receptors were blocked by bicuculline (a GABA receptor antagonist) in combination with MK801, the PSD-95 degradation did not change significantly.Conclusion The results suggest that A?-induced downregulation of PSD-95 depends on NMDAR activity, and extrasynaptic NMDA receptors may be involved in A?-induced synaptic protein degradation.