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.

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.

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.

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 .

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 .

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

Objective To observe the distribution of cornea Q value in adult myopia,and its relationship with age,sex,eye and refraction.Design Prospective case series.Participants Consecutive 510 patients (1020 eyes) of myopia of adults.Methods Cornea Q values were obtained with OrbscanⅡz Anterior Segment Analysis System in all subjects of adult myopia.Normal distribution test of Q value and correlation analysis with sphere,cylinder,sex,and age were performed.Main Outcome Measures Q value of cornea,corre- lation coefficient.Results In 1020 eyes of adult myopia,the mean Q value was-0.27?0.16 (range from-0.86 to 0.25) with near nor- mal distribution.The difference of Q value between right eyes and left eye was not statistically significant (P=0.675).The Q value be- tween male (-0.26?0.15) and female(-0.27?0.17) was not statistically difference(P=0.697).No significant relation was found Q value with either sphere (r=0.057,P=0.068) or cylinder (r=0.044,P=0.156).Mean Q value of below 20 years old was maximal,-0.24,while over 40 years old was minimal,-0.36,and the difference were statistically significant (P=0.000).Conclusions Q value of cornea has negative shift with the increase of age,especially in over 40 years old.Q value of cornea has no relationship with left or right eyes,sex and refraction,but it is highly customized.

Objective To quantitatively detect serum Golgi protein 73 (GP73) and alpha-fetoprotein (AFP) in the patients with hepatocellular carcinoma (HCC) ,chronic hepatitis liver cirrhosis and normal healthy individuals ,to compare the detection rate of GP73 and AFP and to investigate the clinical significance of GP73 for diagnosing HCC .Methods The serum samples in normal healthy individuals and the patients with chronic hepatitis liver cirrhosis and HCC were collected and detected GP 73 and AFP by the enzyme-linked immunosorbent assay (ELISA) and the chemiluminescence method .Results The detection rates of GP73 and AFP in HCC were 75 .61% and 40 .24% respectively ,GP73 was significantly higher than AFP (P<0 .01);In chronic hepatitis liver cirrhosis ,the detection rates of GP73 and AFP were 12 .58% and 41 .67% respectively ,the detection rate of GP73 was significantly lower than that of AFP (P<0 .01);In normal healthy individuals ,the detection rates of GP73 and AFP were 1 .67% and 6 .67% re-spectively ,the difference between them had no statistical significance (P>0 .05) .The specificity of GP73 and AFP in the normal healthy individuals and the patients with chronic hepatitis kive cirrhosis were 93 .42% and 77 .78% respectively .Areas under the ROC curves of GP73 and AFP were 0 .934 1 and 0 .806 6 respectively .The HCC detection rate of the combined detection of GP73 and AFPT was 87 .80% .Conclusion The GP73 detection rate and content are extremely low in the normal healthy individuals ,the GP73 detection rate is 12 .58% in chronic hepatitis liver cirrhosis and up to 75 .6% in HCC .The ROC curve analysis and the detec-tion rate are basically consistent .GP73 has the high detection rate and strong specificity in the patients with HCC ,which is the pre-ferred marker for early diagnosis of HCC .The joint detection of GP73 and AFP can improve the early diagnosis rate of HCC .

Objective To develop a HPLC method for determining the content of riparsaponin in Homonoia riparia Lour.Methods The determination was performed on the HYPERSILBDS-C18(200 mm?4.6 mm,5 ?m) with mobile phase consisted of acetonitrile-water(75∶25) at a flow rate of 1.0 ml/min.The detection wavelength was set at 203 nm,the column temperature was 30 ℃,and the column pressure was 10.0 MPa.Results There was a good linear relationship for riparsaponin over the ranges of 5 to 500 ?g/ml(r=0.999 8).The average recovery was 99.44%,and RSD was 0.52%(n=15).Conclusion The method has good reproducibility and high precision.It can be applied in quality control of Homonoia riparia Lour.