With an increasing prevalence all over the world,diabetes mellitus is considered as a potential cause of liver cancer in patients with non-viral hepatitis.Whether diabetes mellitus is the cause of liver cancer and related pathogenesis remain unknown.The article reviews recent large-sample cohort studies and confirms that diabetes mellitus increases the incidence rate of liver cancer and affects its prognosis.This article also investigates the association of hepatitis C,obesity,and nonalcoholic fatty liver disease with diabetes mellitus and liver cancer and finds that insulin resistance and activation of chronic inflammatory factors may be involved in the generation and proliferation of cancer cells.This article elaborates on the influence of anti-insulin resistance drugs on the development and progression of liver cancer and points out that diabetes mellitus may be the cause of liver cancer.Effective control of insulin resistance can help to reduce the development and progression of diabetes-associated liver cancer.

Objective To explore the effect of Contract Learning Methodology in teaching of clinical nursing.Methods 88 nursing students were randomized into the control group(n=46)and experiment group(n=42).The former and the latter adopted the Contract Learning Methodology and conventional teaching methodology,respectively.The two groups were assessed and compared in terms of their scores of clinical nursing theory and manipulation.Results The students in the experiment group were comprehensively better then those in the control group in terms of theoretical and manipulative exams,writing of nursing histories, writing of reading reports,basic nursing,communicating ability and comprehensive achievements(P<0.01).Conclusion The Contract Learning Methodology may fortify the sense of discipline in nursing students,enhance the sense of teaching in teachers and therefore propel the quality of teaching and learning.

To determine the lysis spectrum of Yersinia enterocolitica bacteriophage phiYe-F10 and to analyze the relationship between the lysis ability of phiYe-F10 and the virulence gene of Yersinia enterocolitica. To observe the lysis ability of the phage phiYe-F10 to the different Yersinia strains with the double-layer technique. The strains used in this study including 213 of Yersinia enterocolitica and 36 of Yersinia pseudotuberculosis and 1 of Yersinia pestis. The virulence genes of these Yersinia enterocolitica (attachment invasion locus (ail) and enterotoxin (ystA, ystB) and yersinia adhesin A (yadA), virulence factor (virF), specific gene for lipopolysaccharide O-side chain of serotype O : 3 (rfbc) were all detected. Among the 213 Yersinia enterocolitica, 84 strains were O : 3 serotype (78 strains with rfbc gene), 10 were serotype O : 5, 13 were serotype O : 8, 34 were serotype O : 9 and 72 were other serotypes. Of these, 77 were typical pathogenic Yersinia enterocolitica harboring with virulence plasmid (ail+, ystA+, ystB-, yadA+, virF+), and 15 were pathogenic bacterial strains deficiency virulence plasmid (ail+, ystA+, ystB-, yadA-, virF-) and the rest 121 were non pathogenic genotype strains. PhiYe-F10 lysed the 71 serotype O : 3 Yersinia enterocolitica strains which were all carried with rfbc+, including 52 pathogenic Yersinia enterocolitica, 19 nonpathogenic Y. enterocolitica. The phiYe-F10 can not lysed serotype O : 5, O : 9 and other serotype Y. enterocolitica, the lysis rate of serotype O : 3 was as high as 84.5%. The phiYe-F10 can not lysed Yersinia pseudotuberculosis and Yersinia pestis. Yersinia phage phiYe-F10 is highly specific for serotype O : 3 Yersinia enterocolitic at 25 degrees C, which showed a typical narrow lysis spectrum. Phage phiYe-F10 can lysed much more pathogenic Y. enterocolitica than nonpathogenic Y. enterocolitica.
Bacterial Proteins ; genetics ; metabolism ; Bacteriophages ; genetics ; isolation & purification ; physiology ; Host Specificity ; Virulence Factors ; genetics ; metabolism ; Yersinia enterocolitica ; genetics ; metabolism ; virology

Objective To study the treatment effect of gonadotropin releasing hormone agonist?α( GnRH?α) different drug consolidation therapy time on endometriosis patients received endometriosis laparoscopic surgery?Methods Seventy cases endometriosis patients received endometriosis laparoscopic surgery in the People's Hospital of Meizhou from May 2012 to March 2014 were enrolled for study and randomly divided into 6 months group and 3 months group according to different time of GnRH?αtreatment?Then hormone levels, inflammatory mediators, follow?up condition and treatment outcome were compared between the two groups?Results The total effective rate of 6 months group was 97?14%( 34/35) ,significantly higher than that of 3 months group(80?00%(28/35)),the difference was significant(χ2 =5?081,P<0?05)?Serum follicle stimulating hormone( FSH) ,progesterone( LH) ,estradiol( E2) levels of 6 months group were significantly lower than 3 months group,the differences were significant((2?42±0?33) U/L vs?(3?79±0?42),(3?49±0?45) U/L vs?(5?12±0?60) U/L,(89?48±10?23) ng/L vs? (130?48±16?85) ng/L;t=15?174,12?858,12?305;P<0?05)?Serum TNF?α,IL?6,IL?8 levels of 6 months group were significantly lower than 3 months group,the differences were significant((18?48±2?23) ng/L vs?(31?49±4?05) ng/L,(14?45±2?18) ng/L vs?(23?49 ±2?95) ng/L,(35?29±4?52) ng/L vs? (58?49±7?28) ng/L;t=16?648,14?580,16?017;P<0?05)?The pregnancy rate,pain relief rate of 6 months group were significantly higher than 3 months group(51?43%(18/35) vs?22?86%(8/35),74?29%(26/35) vs?40?00%(14/35)),the recurrence rate was significantly lower than that 3 months group(8?57%(3/35) vs?31?43%(11/35)),the differences were significant(χ2=6?118, 8?400,5?714;P<0?05)?Conclusion 6 months GnRH?α treatment after laparoscopic surgery help to prevent disease relapse,and regulate hormone levels,inhibit inflammatory reaction,then improve the effect of treatment.

Objective To find out present condition and differences in implementation of clinical pathways in hospitals of in China.Methods "Clinical pathway" was entered as a keyword to search in PubMed NCBI Chinese Science and Technology Periodical Database for related literatures in China from 1999 to 2009,analyzing the general implementations of clinical pathways in hospitals in different areas using the SPSS12.0 software.Results A total of 1051 relevant literatures were found.Through data analysis of these literature,differences of implementation of clinical pathways were found for 162 hospitals of different areas.It was found that the differences of total diseases among China's East,West and Central areas are significant statically.Diseases of implementation per hospital in the Central average 16.8,those in the East 8 types,while those for the West 4.4.Tertiary hospitals account for 70% as the main force of clinical pathway implementation,with diseases of implementation up to 13.7,while that under tertiary level down to 2.8.Conclusions Implementation of clinical pathways varies significantly among hospitals in different areas in China.In the process of implementing clinical pathway,appropriate management strategies should be developed according to actual situation in different hospitals in light of policies,hospital management and patient considerations.

Objective To evaluate the effectiveness of domestic exogenous pulmonary surfactant (EPS)-Calsurf in treating full-term neonatal respiratory distress syndrome (RDS).Methods (1) From January 2011 to June 2012,154 full-term neonates with RDS were divided into Calsurf group (74 cases) and Curosurf group (80 cases),comparing differences in changes of arterial blood gas,the length of hospital stay,hospitalization expenses,duration of mechanical ventilation,inspired oxygen time,the incidences of complications and repeated EPS use rates between two groups.(2) In order to compare the effectiveness of different doses of Calsurf in treating full-term neonatal RDS,from July 2012 to March 2013,80 RDS patients who received Calsurf were divided into mild-moderate group (grade Ⅱ ～ Ⅲ on chest X-ray,50 cases) and severe group (grade Ⅳ on chest X-ray,30 cases).Furthermore,each group was divided into two subgroups,which were low-dosage(per-time 30 ～40 mg/kg) and high-dosage group (per-time 30 ～40 mg/kg).Results (1) Before administrating Calsurf and after administrating it at 0.5 h and 6 h,the pH,PaCO2 and PaO2 of RDS patients were no significant difference in two groups (P ＞ 0.05).(2) There were no significant difference between the duration of mechanical ventilation,inspired oxygen time,length of hospital stay in two groups (P ＞ 0.05).But the hospitalization expenses in Calsurf and Curosurf groups were 28.778 versus 31.827 thousand yuan,respectively,with the average reduction of 9.6％ in Calsurf group (P ＜ 0.05).(3) There were no significant difference between the morbidities and mortalities of multiple organ failure,persistent pulmonary hypertension,acute renal failure and pneumothorax in two groups (P ＞ 0.05).(4) In mild-moderate grade RDS patients,the low-dosage or high-dosage of Calsurf had similar effectiveness in improving bloog gas (P ＞ 0.05),the repeated Calsurf use rates of both subgroups were 16.0％ (4/25) and 20.0％ (5/25) (P ＞ 0.05).While in severe RDS patients,high-dosage Calsurf got a better effectiveness in improving bloog gas than low-dosage Calsurf(P ＜ 0.05).Meanwhile,the repeated Calsurf use rates of the low-dosage and high-dosage subgroups were 20.0％ (3/15) and 33.3％ (5/15),with a 40％ reduction in high-dosage subgroup.Conclusion (1) Both Calsurf and Curosurf can significantly improve the conditions of hypoxemia and hypercapnia,moreover,the length of hospital stay and duration of mechanical ventilation of both groups are similar,with less hospitalization expense in Calsurf group.(2) Both low and high-dosage Calsurf have similar curative effect on mild-moderate RDS,but for severe RDS,high-dosage Calsurf works better,reducing the repeated EPS use rate to some extent.

Objective To determine the adverse effects of fetal growth restriction (FGR) on the development of fetal cerebral function.Methods Sixty small for gestational age (SGA) and 40 appropriate gestational age (AGA) infants with a gestational age ranging from 37 weeks to 40+6 weeks who were hospitalized in the Ba Yi Children's Hospital Affiliated to Beijing Military General Hospital were included in this study.Patients with fetal distress,birth asphyxia,hyperspasmia,intracranial hemorrhage,periventricular leukomalacia,intracranial infection,septicemia and congenital abnormalities were excluded from the study.Amplitude-integrated electroencephalography (aEEG) was used to monitor the baby's cerebral function within three days after birth.The monitoring time was two to four hours in each infant.The observational indices included continuity,sleep wake cycling (SWC),interburst interval (IBI),minimum voltage and maximum voltage.Student's t test,Chi-square test and analysis of variance were used to compare differences between the groups.Results Continuity:the frequency ofaEEG continuity in the SGA and AGA groups was 15.0％ (9/60) and 70.0％ (28/40),respectively (x2=31.14,P=0.00).SWC:the frequency of aEEG SWC in the SGA and AGA groups was 15.0％ (9/60) and 70.0％ (28/40) (x2=31.14,P-0.00).IBI:the frequency of IBI in the SGAandAGAgroups was (14.55±0.75) s and (5.09±0.89) s (t=57.21,P=0.00).Maximum voltage:the maximum voltage in the SGA and AGA groups was (10.40± 2.61) t V and (16.42± 5.53) μ V (t=-6.43,P=0.00).Minimum voltage:the minimum voltage in the SGA and AGA groups was (4.02± 1.61) μ V and (6.98±3.82) μV (t=4.63,P=0.00).Lower birth weight,hypoglycemia (without hypoglycemic encephalopathy) or hyperbilirubinemia (without bilirubin encephalopathy) had no significant influence on fetal cerebral function (all P＞0.05).Conclusions SGA infants have poor continuity,absence of SWC,longer IBI,and lower maximum and minimum voltage,which suggests that FGR,to an extent,has an adverse influence on the development of fetal cerebral function.

Objective To evaluate the value of lung sonography in diagnosis of neonatal pulmonary diseases and to provide a reliable and simple method for diagnosing neonatal pulmonary diseases.Methods From May 2012 to August 2012,105 newborns who admitted into Bayi Children's Hospital were enrolled into this study,including respiratory distress syndrome 40 cases (three of them with difficulty in withdrawing mechanical ventilation),meconium aspiration syndrome 17 cases,wet lung of newborn 17 cases and 30 health neonates without lung diseases.Lung ultrasound was performed at bedside by a single expert physician within the first 24 h of life.All patients with neonatal lung diseases were diagnosed by clinical manifestations,arterial blood gas analysis and chest X-ray.Results (1) Lung sonography of normal neonates showed hypo-echo (black),smooth and clear hyper-echoic pleural line.A line was hyper echo too.(2) All 40 neonates with respiratory distress syndrome showed lung consolidation with air bronchograms; abnormal pleural line,disappeared A-lines,pleural effusion and alveolar-interstitial syndrome.Five out of the 40 (12.5％)infants showed pleural effusion.(3) All 18 meconium aspiration syndrome infants showed focal lung consolidation under pleural membrane,alveolar-interstitial syndrome,atypical changes of abnormal pleural line and disappeared A-line in lesion area with lung sonography.(4) All infants with wet lung of newborn (100.0％,17/17) showed double lung point,with which all wet lung of newborn could be diagnosed.(5) Differential diagnosis of respiratory distress syndrome with wet lung of newborn:five infants with severe dyspnea showedwhite lung in X-ray and were diagnosed as respiratory distress syndrome,while sonography only showed severe lung edema and one infant showed pleural effusion which was in accordance with wet lung of newborn,so was their courses of disease.(6) Three cases of respiratory distress syndrome showed dyspnea after withdrawing mechanical ventilation,and lung sonography showed local atelectasis but normal in X-ray.Conclusions Lung ultrasound has many advantages,such as accurate,reliable,no radiation damage,low-cost and simple; therefore,it is feasible in neonatal ward.

This article summarized the management status of scientific research fund of our hospital. It focused on the whole process management which included the establishment,application and permission of the fund,supervision and tracking of the granted projects.All the management process was dealt with the management mode including standard management,scientific management and tracking management.Some effective experiences were obtained from the whole process management.

Objective To analyze the mammographic features and pathological characteristics among different molecular subtypes of breast cancer.Methods The results of 210 cases breast cancer identified by postoperative pathology were collected and classified to three groups;Luminal,HER-2(+)and TNBC(triple negative breast cancer)by molecular subtypes.Three groups'mammograph-ic features and pathological characteristics were compared.Results 210 cases included 147 Luminal cases,30 HER-2 (+)cases and 33 TNBC cases.There were statistically significant difference between tumor grading and lymph node metastasis (P <0.05).Three groups had statistically significant difference among mass number,mass margin and calcification incidence(P <0.05),and had no sta-tistically significant difference between mass size and shape(P >0.05).The mammographic features of Luminal molecules subtypes showed more mass with burr,HER-2(+)molecules subtypes showed no fixed features but more calcification incidence than other groups,TNBC molecules subtypes showed merely mass with clear margin and less calcification.Conclusion The mammographic fea-tures and pathological characteristics of different molecular subtypes of breast cancer are significant differences.