Objective To investigate the effect of bundle strategy of diagnosis and treatment on preventing hospital acquired pneumonia in intensive cancer patients.Methods Two hundred and sixty-five patients as control group were treated by regular preventive measures,and 292 cases as intervention group were treated by bundle strategy including the control application of antibiotics,hand hygiene,oral care,isolation of multi-drug resistant,elevation of bedside,management of respiratory tract and appropriate sedation and analgesia et al.Compare the hospital acquired pneumonia incidence,attribution mortality,duration of mechanical ventilation,stay-time in ICU,hospital acquired pneumonia antibiotics defined daily doses system and positive rate of multi-drug resistant infection between two groups.Results With the bundle treatment,the decreases of the hospital acquired pneumonia Incidence,duration of mechanical ventilation,stay-time in ICU and hospital acquired pneumonia Antibiotics daily doses system were significant(P＜ 0.01),and the positive rate of hospital acquired pneumonia attribution mortality and MDR infection were no statistical significance (P ＞ 0.05).Conclusion The bundle strategy of diagnosis and treatment could reduce the hospital acquired pneumonia incidence and the length-time in hospital.

DNA methylation is the main profile of epigenetics .DNA methyltransferases ( DNMTs) is the main regulatory enzyme during DNA methylation .The activation of DNMTs ,the hypermethylation and low expres-sion of some tumor suppressor genes are involved in the carcinogenesis and development of various human canc -ers,which is a biomarker of poor prognosis .Both of the polymorphism of DNA methyltransferases ( DNMT3b) and tobacco smoking are risk factors of tumorgenesis .The targeted therapy of DNMTs is very popular due to its low cy-totoxity.This review will focus on new progress of the research on DNMTs in pathogenesis of carcinoma .

Objective To evaluate the value of revised Geneva score, Daniel ECG score and age-adjusted D-dimer for predicting pulmonary embolism(PE).Methods A total of 91 cases suspected as pulmonary embolism were collected, and 52 cases were diagnosed as pulmonary embolism by computed tomographic pulmonary angiography(CTPA) results.Receiver operating characteristic(ROC) curves and diagnostic test evaluation indexes were used to evaluate the probability of PE predicted by the revised Geneva score,Daniel ECG score, age-adjusted D-dimer and combination of these two clinical scores and age-adjusted D-dimer.Results The confirmed PE was 21.4% with a low probability(revised Geneva score 0~3 points),55.4% in intermediate probability(4~10 points),85.7% in high probability(score≥11 points).The prevalence of PE was 33.3% with a low clinical probability (Daniel ECG score<2 points)and 70.7% with a high clinical probability(Daniel ECG score≥2 points).The sensitivity and specificity of age-adjusted D-dimer in predicting pulmonary embolism were 92.3%,69.2%.The area under curve of the ROC curve(AUC)in the revised Geneva score and Daniel ECG score has no significant difference(Z=0.979).The negative predictive value of the revised Geneva score, Daniel ECG score combined with D-dimer in pulmonary embolism were 100.0% and 87.5%.Conclusion All of revised Geneva score, Daniel ECG score and age-adjusted D-dimer have certain predictive value on pulmonary embolism , and the revised Geneva score combined with age-adjusted D-dimer can be more safely exclude pulmonary embolism.

Objective To analyze the clinical efficacy of traditional medicine for adverse drug reaction of highly active antiretro-viral therapy(HAART)medication.Methods 60 patients with AIDS received conventional treatment with HAART were randomly divided into the treatment group and control group.Traditional medicine was observed in patients of treatment group for more than 3 months,and several necessary test items were recorded before and after research.Results After therapy,the clinical symptoms weight,Karnofsky performance scale(KPS)and CD4 cells of the patients in two groups was obviously improved.Comparing with the control group,treatment group had better significant efficiency in the symptom,increased CD4 cell(P<0.05)and KPS(P<0.05).Inefficiency of ALT and AST in treatment group was lower than control group,while efficiency and stability had no signifi-cant increase.Inefficiency of WBC,RBC,PLT and MCHC in treatment group was significant higher than control group.Conclusion Traditional medicine combine with HAART for HIV/AIDS can decrease the incidence of adverse drug reaction of HAART medi-cation.For patients,the combination have the efficiency on protecting the safety of prescription and improving the routine blood test.The Traditional medicine may play a role in attenuation and synergy and improve the condition and prognosis of patients.

Brugada Syndrome ; etiology ; physiopathology ; Coronary Artery Disease ; physiopathology ; Coronary Vasospasm ; physiopathology ; Electrocardiography ; Humans ; Male ; Middle Aged

Angioplasty, Balloon, Coronary ; instrumentation ; Female ; Humans ; Middle Aged ; Prosthesis Failure ; Stents

Objective:To investigate the clinical features and prognostic factors of primary ovarian lymphoma(POL). Methods:A retrospective review was performed based on the clinical records of 14 POL cases treated at Tianjin Medical University Oncology in-stitute Hospital verity from 2000-6 to 2010-5. Results:The median age of patients was 47 years at presentation(range 28~62years). Ab-dominal pain was the most common initial symptom. The majority of histological subtype was B cell lymphoma, above 50%of which is diffuse large B-cell non-Hodgkin's lymphoma. A R0 resection was carried out in 2 patients who were lost to follow-up soon after sur-gery. 11 patients were treated by CHOP, FC or CHOPE chemotherapy. Chemotherapy combined with rituximab were given to 5 pa-tients. Until now, 5 patients were alive, 6 patients died, and only one patient was lost to follow up after therapy. Conclusion:POL is an extremely rare lymphoma. The ultimate diagnosis depends on histopathologic examination. Primary ovarian non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after oophorotomy is recommended. B cell lymphoma preferred to use rituximab combination chemotherapy. Abdominal cavity chemotherapy prophylaxis and irradiation can decrease the probability for recurrence .

Acute Disease ; Adult ; Female ; Herbicides ; poisoning ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Retrospective Studies ; Young Adult

Objective To investigate the clinical significances of thyroid function changes in patients with post-stroke depression(PSD). Methods Sixty two cases with acute cerebral infarction (CI) were stratified into two groups by Zung self-rating depression scale, single cerebral infarct patients group (CI group) and PSD group. Serum levels of FT3, FT4 and TSH of the patients were detected on 2 days,7days,14 days and 21days after admission. Results ①On each time point after admission, FT3 levels in PSD group were lower than those in CI group. FT3 levels in the two groups on the 7 days were higher than those on 2 days(2.04±0.53 vs 1.28±0.19, 1.43±0.91 vs 1.07±0.37, P <0.05).On the 14 and 21 days, levels of FT3 in the PSD group were continuously increased.②On the 2 days and 7 days after admission, FT4 levels in PSD group were higher than those in CI group. FT4 levels in the two groups on the 14 days were lower than those on 7 days(1.52±0.18 vs 2.09±0.26, 1.57±0.31 vs 2.28±0.38, P <0.05). ③On the 2 days after admission,the TSH level in the PSD group were lower than that in CI group(2.02±0.36 vs 2.27±0.49,P <0.05). Conclusion The results indicated that the hypothalamic-pituitary-thyroid axis plays important role in the pathogenesis of PSD.

Objective To investigate the effects of SIRT1 gene expression inhibited by shRNA on proliferation and apoptosis of pancreatic carcinoma PANC1 cells. Methods The eukaryotic expression plasmid of short hairpin RNA (shRNA) targeting SIRT1 gene (SIRT1-shRNA) was constructed as pGC-shRNA and transfected into PANC1 cells. There were shRNA-control transfection group and untransfectian control group. The expressions of SIRT1 mRNA and protein were detected with real-time PCR and immunocytochemistry assay, respectively. The growth rate of PANC1 cells was detected by MTT. Activity of caspase-3 and caspase-9 were detected by ELASA. Expressions of Bax, Bcl-2 proteins were determined by Western blotting. ResultsCompared with untransfected group, the inhibition rate of expressions of SIRT1 mRNA and protein were (76.2 ± 10.4) % and (80.1 ± 11.6) %, cytostasis rate was (45.1 ± 6.5) %, caspase-3 and caspase-9 activity was significantly increased, Bax protein was up-regulated, while Bcl-2 protein was down-regulated 48h after transfection. Conclusions Recombinant expression plasmid SIRT1 shRNA could significantly inhibit the expression of SIRT1 gene, and the mechanism may include increased caspase-3 and caspase-9 activity and Bax protein up-regulation, as well as Bcl-2 down-regulation.