Objective To investigate the clinical pathway in the health education for prevention of postpartum urinary retention and effect evaluation. Methods 150 cases who completed delivery in our hospital were set as the observation group, they received health education of clinical pathways. 150 pregnant women who completed delivery in our hospital in the past were named as the control group, they were given traditional health education. The incidence rate of urinary retention was compared between the two groups. Results 7 cases, accounting for 4.67% of urinary retention occurred in the observation group, 24 patients, accounted for 16.00% of urinary retention occurred in the control group, the incidence of urinary retention in the experimental group was significantly lower than the control group. Conclusions Application of clinical pathway in the health education for prevention of postpartum urinary retention has good clinical value, can largely reduce the incidence of urinary retention.

Objective To discuss the influence of hardiness conception utilization on rehabilitation of breast cancer patients. Methods 80 breast cancer patients were involved in this trial, the responsible nurses collected and analyzed the data of patients by interview, observation, and investigation question-naires, then gave patients individual directions of hardiness conception according to stage and primary and secondary of the data to arouse the hardiness characteristic of patients. The application results underwentχ2 test. Results The number of psychical problems decreased and the need of information about breast cancer increased obviously after the direction. Conclusions The utilization of hardiness conception can strengthen patients' confidence, raise their treatment compliance, and promote their rehabilitation.

Objective The aim of this study was to investigate the impact of constructing national key clinical specialty on high quality nursing service.Methods Using the Colaizzi 7-step analysis method to analyze the information,which through using the phenomenology research methods by making interviews with 14 clinicians,nurses and nursing administrators.Results The clinical medical staffs experienced the construction of key clinical specialist,to some extent,that would promote the development of nursing discipline,enhancing the environment and equipment in hospital,having improvement on the ability of nursing service and quality simultaneously,and then the cooperation between medical staffs and patients were more closely,while nurses bearing increased work pressure,with obviously job burnout.Conclusions The national key clinical specialist construction would effectively launching nursing quality care in depth and improving patient satisfaction with medical care,while the working pressure of nurses and the imperfection of post performance management restricted the development of nursing discipline.

OBJECTIVETo study the relationship between sensitivity to 5-FU and the status of a panel of microsatellite loci in three human colon cancer cell lines.

METHODSCell viability in several concentrations of 5-FU was assessed by the MTT test. Expression of hMSH2 and hMLH1 in LoVo, SW480 and SW1116 cells were analyzed by immunocytochemical staining.Ten mononucleotide and dinucleotide microsatellite loci were analyzed by the PCR-SSLP-silver staining method.

RESULTSBy MTT assay, it showed that LoVo cells were more sensitive than SW480 and SW1116 cells (0.8 micromol/L,2.2 micromol/L and 1.9 micromol/L, respectively, P < 0.05). By immunocytochemical staining, hMSH2 was expressed in SW480 and SW1116 cells but not in LoVo cells, while hMLH1 was positive in all three cell lines. The PCR-SSLP-silver staining of 10 microsatellite loci revealed that LoVo cells had a different pattern of electrophoretic bands compared with SW480 and SW1116 cells, manifesting both additions and band-shifts.

CONCLUSIONTogether with hMSH2 and hMLH1, the status of a panel of microsatellite loci may be used as convenient predictors for drug-optimization or prognosis-assessment in colorectal cancer patients before chemotherapy.

Adaptor Proteins, Signal Transducing ; Antimetabolites, Antineoplastic ; pharmacology ; Base Pair Mismatch ; Carrier Proteins ; Colorectal Neoplasms ; drug therapy ; genetics ; pathology ; DNA Repair ; DNA-Binding Proteins ; Fluorouracil ; pharmacology ; Humans ; Immunohistochemistry ; Microsatellite Repeats ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; Neoplasm Proteins ; genetics ; Nuclear Proteins ; Polymerase Chain Reaction ; Proto-Oncogene Proteins ; genetics ; Tumor Cells, Cultured

OBJECTIVETo get a complete cDNA sequence of B2 and evaluate the correlation on structure and expression between B2 and insulin like growth factor binding protein related protein 1 (IGFBP-rP1) in colorectal carcinomas, paired normal tissues, adenomas, tissues adjacent to the tumor, and colorectal carcinoma cell lines.

METHODS5'RACE (rapid amplification of cDNA end) was applied to get the sequence of the 5' end of B2. Semi-quantitative RT-PCR and immunohistochemistry were used to detect the expression of B2 in colorectal cancer tissues and cell lines (SW480, SW1116, SW620, HCT8, CoLo205 and LoVo).

RESULTSA sequence of 1,125 bp was obtained by combining the sequence from 5'RACE product and the known sequence of B2. It shared 1,122/1,125 identities with IGFBP-rP1. At the level of mRNA, the expression of B2/IGFBP-rP1 was high in colorectal carcinomas, moderate in adenomas and tissues adjacent to tumor, low in normal tissues (P < 0.05). Five cell lines except SW480 showed no expression of B2/IGFBP-rP1. A significant difference was obtained in the immunoreactivity of B2/IGFBP-rP1 between normal tissue and cancer (P < 0.05). In 28.9% (22/76) samples, cancer cells locating at the invasive front of cancer nest had a stronger staining of B2/IGFBP-rP1 than those surrounding the lumen. These samples had also an increased frequency of lymph node metastases, increased depth of invasion and a stronger staining of B2/IGFBP-rP1 than in other samples (P < 0.05).

CONCLUSIONSB2 is the same gene as IGFBP-rP1. Overexpression of B2/IGFBP-rP1 may play an important role in the initiation and promotion of colorectal cancer. Its overexpression in invading tumor cells may be linking with an increased potential of invasion.

Adenocarcinoma ; metabolism ; secondary ; Adenoma ; metabolism ; pathology ; Aged ; Cell Line, Tumor ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Humans ; Insulin-Like Growth Factor Binding Proteins ; biosynthesis ; genetics ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; RNA, Messenger ; genetics ; Rectal Neoplasms ; metabolism ; pathology ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo determine the anatomical variation and classification of ventricular septal defect (VSD) using echocardiography for percutaneous catheter closure in eligible cases.

METHODThe isolated ventricular septal defect was diagnosed with echocardiography in 240 patients , and 167 patients screened by transthoracic echocardiography were suitable for percutaneous catheter closure, but only 62 with isolated perimembranous VSD voluntarily received the procedure.

RESULTSThe procedure was successful in 58 patients, with a success rate of 93.5% with Amplatzer device. The diameter of VSD ranged from 2.4 to 13.9 (mean 5.3-/+2.0) mm with echocardiography, and the size of Amplatzer device ranged from 4-18 (mean 8.3-/+2.9) mm. Perimembranous ventricular septal defect was complicated by aneurysm formation in 22 patients. Residual trivial or mild shunt was seen in seven (12%) patients at 24 h and one (1.7%) patient at 3 months. Seven (12.1%) patients developed heart block, 3 (5.2%) had intermittence and transient complete heart block, and one had transient second degree atrioventricular block disappearing in 3 to 10 days, and 3 (5.2%) patients had complete right bundle branch block lasting for one month. None of the patients developed significant aortic regurgitation (P>0.05), although 22 showed a superior margin of the defect less than 3 mm from the aortic valve. The mean distance from the aortic valve was 3.7-/+2.7 (1.0 to 10.5) mm. No significant mitral and tricuspid regurgitation occurred in these patients. Four patients had unsuccessful procedures.

CONCLUSIONSPercutaneous closure with Amplatzer device can be carried out successfully in a majority of suitable defects screened using transthoracic echocardiography. Echocardiography can exactly demonstrate the anatomical variation and classification of ventricular septal defect in adults. Attention should be given to the misdiagnosis by echocardiography of a doubly committed defect as a perimembranous outflow defect. Heart block can be an important complication of the procedure.

Adolescent ; Adult ; Aged ; Balloon Occlusion ; instrumentation ; methods ; Cardiac Catheterization ; methods ; Child ; Child, Preschool ; Echocardiography ; methods ; Female ; Heart Septal Defects, Ventricular ; classification ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Prosthesis Implantation ; methods ; Septal Occluder Device ; Young Adult

OBJECTIVETo describe the morphological features of congenital heart defects and their spatial orientations to the neighboring structures in special two-dimensional echocardiographic views.

METHODSConventional two-dimensional echocardiographic sections were obtained in 45 patients with atrial septal defect (ASD) and 15 with ventricular septal defect (VSD) before the en face imaging, a special echocardiographic view, was performed using a transthoracic probe for morphological characterization of the ASD and VSD. En face views of the secundum ASD and perimembranous and outflow tract or doubly committed subarterial VSD were imaged on the interatrial septal section and inflow and outflow interventricular septal section at parasternal or apical position, respectively.

RESULTSThe special echocardiographic section provided en face plane views of the congenital heart defects in 35/43 (81%) of secundum ASD and 10/15 (67%) of VSD patients, and allowed full assessment of their size, shape, circumference and spatial orientations to the neighboring structures, showing also the relationship between two or multiple defects.

CONCLUSIONThe special transthoracic two-dimensional echocardiography not only displays the morphological features of ASD and VSD, but also provides additional information for making clinical decisions.

Adolescent ; Adult ; Child ; Child, Preschool ; Echocardiography ; methods ; Female ; Heart Defects, Congenital ; diagnostic imaging ; Heart Septal Defects, Atrial ; diagnostic imaging ; Heart Septal Defects, Ventricular ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Young Adult

Objective To compare the clinical characteristics,and outcomes of patients with heart failure with different left ventricular ejection fractions (LVEF).Methods A total of 1 182 hospitalized patients with heart failure (HF) were enrolled and retrospectively studied in the present study.The patients were stratified by LVEF as reduced (HFrEF,LVEF ＜ 40％,n =313),mid-range (HFmrEF,40％ ≤ LVEF ＜50％,n =287) and preserved (HFpEF,LVEF≥50％,n =582) ejection fraction groups.Among the 1 182 cases,941 of them (81.3％,84.9％,and 84.0％ inHFrEF,HFmrEF and HFpEF groups,respectively) were followed up for an median duration of 27.3 months.Results (1) Among the study patients,26.5％ were in HFrEF,24.3％ in HFmrEF,and 49.2％ in HFpEF groups.(2) Ischemic heart disease with HFmrEF was more frequent than that in patients with HFrEF.The average age,percentage of female subjects,systolic blood pressure,uric acid,N terminal B-type natriuretic peptide precursor (NT-proBNP),hemoglobin,and the incidence of hypertensive heart disease,anemia,atrial fibrillation in patients with HFmrEF were higher than those in patients with HFrEF,but lower than those in patients with HFpEF (all P ＜0.01).(3) The all-cause cumulative mortality was 10.8％ at 1 year,20.6％ at 2 years and 35.9％ at 5 years.No difference was observed in the all-cause cumulative mortality at 1 year,2 years,5 years among the three groups (all P ＞ 0.05).Conclusions The HFmrEF patients,as a new and distinct group,were with many intermediate characteristics compared with HFrEF and HFpEF subjects.However,the all-cause mortality was not significantly differeut among HF patients with different LVEF.

OBJECTIVETo study the expression of p53 protein, incidence of p53 gene mutation and microsatellite instability in ulcerative colitis, dysplasia of colonic mucosa and ulcerative colitis-associated colorectal cancer.

METHODSP53 protein expression was detected by immunohistochemistry in 70 specimens from 21 cases of ulcerative colitis and 25 colonic mucosa specimens from normal subjects. The specimens of ulcerative colitis were examined for the mutation in exon 5, 6, 7, 8 of p53 gene with microdissection-PCR-SSCP/HA-clone-sequencing technique and the alterations in 10 microsatellite loci with microdissection-PCR-SSLP-clone- sequencing technique.

RESULTNone of 25 normal specimens was p53-positive immunohistochemically, while 4/21 of ulcerative colitis specimens were p53-positive. P53- positive rate in inflammatory mucosa of ulcerative colitis specimens was 0/5, while that was 1/7, 2/7 and 1/2 in low-grade displasia (LGD), high-grade displasia (HGD) and carcinoma, respectively. The abnormal exons were detected by SSCP and confirmed by sequencing in 2 out of 21 cases: one was exon 6 in a case with carcinoma and the other was exon 8 in a HGD case; both had positive P53 expression. Two cases showed positive in Bat26 locus by SSLP: one was a LGD case, the other was a case of carcinoma, who also had abnormal exon 6 of p53 gene. Other 9 microsatellite loci, (TGF beta RII(A)(10), IGFIIR(G)(8), IGFIIR(CT)(5), TGF beta RII(GT)(3), BAX(G)(8), hMSH3(A)8, hMSH6(C)(8), TCF4(A)(9) and DPC4 (CA)(17)) were showed negative in all cases.

CONCLUSIONP53 gene mutations and microsatellite instability may be one of the mechanisms for higher risk of carcinogenesis in ulcerative colitis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colitis, Ulcerative ; complications ; genetics ; Colorectal Neoplasms ; genetics ; Female ; Genes, p53 ; Genomic Instability ; Humans ; Immunohistochemistry ; Male ; Microsatellite Repeats ; Middle Aged ; Mutation ; Tumor Suppressor Protein p53 ; analysis

OBJECTIVETo screen the differentially methylated DNA sequences between mucosa adjacent to colorectal cancer (MACC) and normal colonic mucosa.

METHODSThe methylated DNA sequences were enriched by methylation CpG islands amplification (MCA), and the differentially methylated DNA sequences between MACC and normal colonic mucosa were isolated by representational difference analysis (RDA). Similarities between the separated fragments and the human genomic DNA were analyzed with BLAST program system in GenBank. With the separated fragment 1A12 as probe, dot blot was used to study its distribution between RDA products (No. 1-4 rounds), MACC (tester) and normal colonic mucosa(driver).

RESULTSTwenty-five differentially methylated DNA sequences were obtained. Preliminary studies indicated that 1A01 fragment was concerned with two different genes (LOC256866 and CECR7), it was located in the first exon of CECR7. 1A12 fragment was located in 5 flanking region of GR6 gene. By dot blot with 1A12 probe, hybridized signals were detected in MCA product of MACC and RDA products of No. 1-4 rounds, respectively. No signal was detected in MCA product of normal colonic mucosa.

CONCLUSIONThe differentially methylated DNA sequences can be isolated effectively between two different tissues with MCA coupled with RDA. Different methylated DNA fragments exist between MACC and normal colonic mucosa and these fragments may be concerned with colorectal cancer.

Adult ; Base Sequence ; Colorectal Neoplasms ; diagnosis ; genetics ; CpG Islands ; genetics ; DNA Methylation ; DNA, Neoplasm ; chemistry ; isolation & purification ; metabolism ; Genetic Testing ; Humans ; Intestinal Mucosa ; metabolism ; Polymerase Chain Reaction ; Sequence Analysis, DNA