Objective To evaluate the prognostic factors of elderly patients with noscomial Candidemia in intensive care unit. Methods A retrospective study was carried out in 75 elderly patients with noscomial Candidemia from 2001 to 2008. Multivariate logistic regression analysis was performed to find the correlations of prognosis with clinical and biochemical parameters. Results A total of 75 Candida strains were isolated from blood. The proportion of non-albicans species reached to 70.7%. Fluconazole-resistant candidiasis was increased. Overall mortality rate was 48.0%.Multivariate logistic regression analysis showed that septic shock, comorbid bacteremia, higher serum creatinine and sequential organ failure assessment (SOFA) score more than 10 were independent predictors for in-hospital mortality (Ward=6.34, 5.15, 8.04, 6.82, all P＞0.05). Conclusions Noscomical Candidemia in elderly critical illness patients leads a high mortality, the proportion of nonalbicans species and fluconazole-resistant candidiasis increase. The blood culture and drug sensitive test should be performed routinely to provide proper evidence for antifungal therapy. Monitoring the high risk factors, effective and reasonable therapeutics are the guarantee for reducing the mortality induced by Candidemia.

Administration, Topical ; Ear, Inner ; pathology ; Humans ; Meniere Disease ; therapy

AlM: To evaluate the clinical efficacy of canalicular intubation combined with external dacryocystorhinostomy ( ext-DCR ) for treatment of chronic dacryocystitis and upper lacrimal duct stenosis.
METHODS:Thirty-three patients (33 eyes) with chronic dacryocystitis and upper lacrimal duct stenosis who underwent canalicular intubation combined ext-DCR were retrospective analyzed. The silicon tube was indwelt for 6mo. All cases were re-examined 1wk;1, 3, 6, 9mo post-operation, flow of tears, pus excretion and lacrimal duct clearance were observed.
RESULTS: Clear lacrimal duct ratio was 100% in all cases during 1wk~6mo post-operation; Silicon tube was removed 6mo post-operation, 3mo after tube removal, rechecking reported 32 cases with clear lacrimal duct (97%) and 1 case with resistant duct (3%). Two cases ( 6%) with minor lacerations, no other complications were observed.
CONCLUSlON: Canalicular intubation combined ext-DCR is an effective treatment for chronic dacryocystitis and upper lacrimal duct stenosis.

Objective To study whether the measure of consumption of iodized salt to prevent iodine deficiency disorders could lead to residents excessive iodine intake in the coastal areas in China.Methods A large population-based cross-sectional study was carried out in four typical costal provinces along the coastline from north to south,including Liaoning,Shanghai,Zhejiang and Fujian.In addition to survey all of its area of Shanghai,the other three provinces' investigation was carried out at urban and rural levels,respectively,including 5 costal cities,5 costal villages and 3 inland rural areas(as a control point) in each province.In each investigated spot,the local water iodine,residents qualified iodized salt consumption rate,per capita daily intake of salt and urinary iodine levels in different populations were investigated.Results A total of 7552 copies of drinking water samples,7996 salt samples and 9873 urine samples of different populations(adults,lactating women,pregnant women and children) were collected from the 4 provinces.Except the coastal cities and counties of Zhejiang province,the qualified iodized salt consumption rates at household were all greater than 90％ in the investigated spots.The median urinary iodine(MUI) of adults and children investigated in the costal areas were in the range of 100 - 299μg/L.The MUIs of lactating women of all investigated areas were all greater than 100 μg/L.The MUI of pregnant women was at an insufficient iodine level which was lower than 150 μg/L in Shanghai,the costal cities of Zhejiang and the coastal counties of Fujian.Conclusions The overall level of iodine nutrition of coastal residents is appropriate; and it is insufficient among pregnant women in some coastal areas; coastal areas should adhere to the salt iodization measures to control iodine deficiency disorders.

Adult ; Child ; Endoscopy ; Fibrous Dysplasia of Bone ; pathology ; surgery ; Humans ; Male ; Nose ; surgery ; Orbit ; pathology

Objective To assess the pubvaginal fascia sling cystourethropexy (PV sling) technique and outcomes of the treatment of female type Ⅲ stress urinary incontinence. Methods From October 2005 to January 2008, 9 women presenting with type Ⅲ stress urinary incontinence were treated with Pubvaginal fascia sling cystourethropexy. All the patients underwent 1 h pad test before discharge and were tested with maximum uroflow rate, volume of postal residual urine, maximum urethral close pressure (MUCP) and abdominal leak point pressure (ALPP) after 3 months. Results The operative time ranged from 60 to 90 min (mean, 75 min). Estimated blood loss ranged from 60 to 100 ml (mean, 76 ml). Intraoperative unilateral bladder perforation occurred in 2 cases. One patient with infection of abdominal incision was cured by changed dressings. The urinary catheter was removed 5 days post-operation. 4 patients had normal urination and 1 patient had urine retention. The recovery following intermittent catheterization was 3-12 days. 8 patients got 3-28 months' follow up. 7 patients were cured with 1 h pad test decreased from preoperative 58 g (45-75 g) to postoperative 1 g (0-2 g), mean residual urine was less 65 ml (0-80 ml). The values of Qmax (ml/s),MUCP (cm H2O) and ALPP (cm H2O) were 10. 5±2. 7, 15. 5±3. 4 and 40. 4±8.2 pre-opreative,and 26.5±3.9, 49.8±6.7 and 98.6± 12.2 3 months post-operative. There were significant differences of these parameters between pre-and post-operation (p＜0.01). Conclusions PV sling could be a safe and effective surgical procedure fortreatment of type Ⅲ female stress urinary incontinence.

OBJECTIVEThis study aims to construct a long-term, osteogenesis-targeting HU-308 drug delivery implant by the layer-by-layer electrostatic self-assembly (LBL) technique, and observe the features of its delayed release in vitro.

METHODSA heparin (Hep) and chitosan (Chi) multilayer was coated on pure titanium using the LBL technique, and the titanium implants were dipped into the solution to load HU-308. The amount of loaded drug and release rates were measured using a UV-Vis spectrophotometer. The relationships between the loading efficiency, release time, and multilayer films were evaluated. The morphology of all the multilayers was characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM).

RESULTSThe results showed that the Hep/Chi self-assembly multilayer was gradually fabricated on the titanium surface. HU-308 was successfully loaded on the titanium implants. The amount of loaded drug increased with the amount of multilayer films, except in the T20 group. In vitro drug release study showed that drug release was more difficult in the system with thicker films, and large amounts of multilayer films decreased the release speed. Both SEM and AFM measurements showed typical LBL deposition of Hep and Chi.

CONCLUSIONThe HU-308 drug delivery implant is successfully fabricated via LBL technology. It could provide sustained release of HU-308 over 30 d. This type of implant may provide a new possi- bility of promoting implant-bone osseointegration for osteoporotic patients.

A rarely reported postoperative complication following biliary surgery,and to discuss its possible mechanism.This article summarizes I reported HSB case that developed after laparoscopic cholecystectomy in our department and 9 other cases reported in literature.HSB occurred most frequently after simple cholecystectomy in addition to post operative bile duct exploration with cholecystectomy or endoscopic retrograde cholangiopancreatography.The main clinical presentation of HSB was paroxysmal colic in the upper abdomen early in the postoperative period,which could be induced after a meal.Imaging revealed subcapsular hepatic fluid collection,and successful treatment involved placement of a percutaneous drain in the biloma.The mechanism of HSB still needs to be clarified even though it is a rarely reported postoperative complication following biliary surgery.We hypothesize,after analyzing these 10 cases,that sphincter of Oddi dysfunction after biliary surgery and the subsequent persistence of high biliary system pressure may be the root cause of HSB formation.More awareness should be paid to the changes of the sphincter's motility after biliary surgery and its related complications (biliary colic,HSB etc.).

Objective To prepare follicle stimulating hormone (FSH) polypeptide modified nanoparticles (NP) in order to achieve specific ovarian tumor targeting. Methods Expression of FSH receptor protein in human liver cancer and ovarian cancer cell lines BEL-7402, SKOV-3 and Caov-3 was detected by immunocytochemistry. The polypeptide fragment of FSH β 81 -95 amino acids (FSHL81-95)was synthesized and covalently coupled to NP. The specific binding of FSHL81-95 and FSHL81-95-NP was examined by fluorescence microscopy and flow cytometry. Results BEL-7402 and SKOV-3 cells were negative for FSH receptor staining, while Caov-3 celia were positive. The diameters of NP were about 100 nm, with a Zeta potential of -25 mV or so. Caov-3 cells showed a more specific interaction with FSHL81-95-NP than SKOV-3 cells (4. 17 ± 0. 86 and 2. 30 ± 0. 21 ; P < 0. 05). The uptake of FSHL81-95-NP was more than NP in Caov-3 cells (4. 17 ± 0. 86 and 0. 41 ± 0. 32 ; P < 0. 05 ). FSHL81-95-NP showed a selective targeting at Caov-3 cells compared with control NP. Conclusion FSH polypeptide modified NP could selectively target ovarian cancer cells expressing FSH receptor, which might contribute to specific endocytosis mediated by FSH receptor.

Objective Comparison of three different molecular assays for the detection and molecular characterization of circulating tumor cells in breast cancer .Methods The retrospective study compared three different molecular assays to detect CTC in the peripheral blood of 30 healthy individuals and 71 benign breast disease patients and 83 early and 84 metastatic breast cancer patients .All samples were collected at the outpatient , inpatient and physical examination department of Sichuan Provincial People ′s Hospital from January 2011 to June 2014.The same cDNAs were analyzed by:singleplex RT-qPCR assay for BCL-2, multiplex RT-qPCR for BCL-2, HER-2, HMAM, and a commercially available molecular assay (AdnaTest BreastCancer ) for GA733-2, MUC-1, HER-2.The positive of CTC were compared among healthy individuals and benign breast disease patients and breast cancer patients .Chi square test was used to compare the expression of gene markers among the three groups , and the agreement of Kappa test was used to evaluate the method.Results (1) Detection rates of early breast cancer by single RT-qPCR, Adna kits and multiple RT-qPCR were 13.3%, 16.9% and 18.1%, respectively , and the detection of metastatic breast cancer were 31.0%, 42.9%and 35.7%, respectively.There were significant differences in the positive of CTC by three molecular assays between healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 4.235 and 4.301, 5.367 and 5.474, 5.894 and 6.023 respectively, P<0.05).There were no differences between benign breast disease patients and early breast cancer patients (The test values were 0.891,0.748 and 0.701 respectively,P >0.05) .There were significant differences between metastasis breast cancer patients and healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 8.429,7.553 and 7.061;10.24, 9.025 and 8.745; 9.658, 8.417 and 8.201 respectively,P<0.05).(2) In early breast cancer: The concordance between AdnaTest and single RT-qPCR was 79.5%while between AdnaTest and multiplex RT-qPCR was 77.1%.No agreement was found among them ( The test values were 1.065 and 1.871, P were 0.371 and 0.258 ) .The concordance between single RT-qPCR and multiplex RT-qPCR was 80.7%.No agreement was found between them (The test values was 2.814, P was 0.156).(3) In patients with overt metastasis:The concordance between AdnaTest and single RT-qPCR was 78.6%( The test values was 10.986).While between AdnaTest and multiplex RT-qPCR was 80.9%( The test values was 9.251 ) . Agreements were found among them ( P was 0.002 and 0.005 respectively ) .The concordance between single and multiplex RT-qPCR was 88.1%( The test values was 12.364 ) .Agreement was found between them (P was 0.001).Conclusions No correlations were found among different molecular methods to detect CTC in the early primary breast cancer , but correlations were found in the metastatic breast cancer , suggesting that different rate of CTC caused by the number of CTC and its heterogeneity should be considered to the clinical diagnosis and treatment of breast cancer while molecular method is used .