Objective To observe the clinical efficacy and security of anti-tuberculosis combined with highdose methylprednisolone in treatment of advanced tuberculous meningitis.Methods 77 patients with advanced tuberculous meningitis in our department were randomly divided into the observation group(39 cases)and the control group (38 cases).All of the patients were given initiate antiphthisie treatment,the control group were added dexamethasone,20mg/d,iv drip,then was maintained after improved;the observation group were added high-dose methyprednisolone(500mg/d)by intravenous injection for five days,then was given methyprednisolone 80mg/d to maintain.Two groups were treated with hormone no more than three months.Then the clinical efficacy and adveme reaction were compared.Results The observation group:32 cases of healing,6 cases of effective,1 case of inefficient,the total effective rate was 97.4%and the control group were 22,8,8,78.9%;the difference of total effective rates in the two groups was statistically significant(x2=7.57,P＜0.05).The time of consciousness restoration and defevesence,the white blood cell count,protein chloride and glucose content of cerebrospinal fluid of the observation group were(2.7±1.3)d,(13±5)d,(112.37±27.57)×106/L,(3.04±0.82)g/L,(32.7±6.4)mmol/L and(1.67±0.65)mmol/L;and the control group were(5.2±2.4)d,(19±6)d,(93.74±20.18)×106/L,(1.92±0.64)g/L,(25.4 ±5.2)mmol/L and(1.04±0.34)mmol/L,the difference was statistically significant(t=5.70,4.77,3.88,6.67,5.48,5.31,P＜0.01);The difference of adverse reaction rate between the two groups was not statistically significant (P＜0.05).Conclusion The clinical efficacy of anti-tuberculosis combined with high-dose methylprednisolone in treatment of advanced tuberculous meningitis was better and had advantages in improving symptoms and signs without enhancing the rate of adverse reaction and it was worth to promote in clinical.

Objective To describe the status of resilience and self-care behaviors in chronic heart failure patients and to explore the relationship between resilience and self-care behaviors. Methods It was a cross-sectional survey. The Connor-Davidson Resilience Scale, the self-care behaviors with heart failure questionnaire and the demographic scale were delivered to 150 chronic heart failure patients in Shanghai Changhai Hospital. Results The score of self-care behaviors was (2.63 ± 2.01) points for chronic heart failure patients. The resilience score was (57.56 ± 8.51) points. The resilience was significantly related to the self-care behaviors(r=0.427, P<0.01), and which explained 32.4%of the total variation. Conclusions The chronic heart failure patients have poor self-care behaviors and resilience. More attention should be paid and more action be taken to improve the resilience, then improve the self-care behaviors of patients.

Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; standards ; In Situ Hybridization ; standards ; Neoplasm Invasiveness ; Receptor, Epidermal Growth Factor ; analysis ; metabolism

AIM: To estimate the efficacy of milrnone in treatment of congestive heart failure. METHODS: 122 cases of chronic congestive heart failure with different etiology were divided into milrinone group and dabutamine group randomly. Milrinone group accepted milrinone (10 mg?d -1 ) for 5 days, and dabutamine group accepted dabutamine (160 mg?d -1 ) for 5 days. The efficacy of treatments was evaluated. RESULTS: The effectiveness rates of cardiac function improvement were 93.9 % and 76.7 % in milrinone group and dabutamine group, respectively (P

OBJECTIVE: To analyze the situation and the related problems of Chinese patent drugs including toxicity components used in pediatrics, and to provide the suggestion for the development of Chinese patent drugs for pediatrics. METHODS: 264 Chinese patent drugs which were used in pediatrics were collected from national drug standards, and compared with toxicity drug list. The utilization of toxicity drugs were analyzed statistically. RESULTS: About half of Chinese patent drugs for pediatric included toxicity components. Major problems are complex resource of toxicity components, overdose of toxicity components, single disease and pattern, unscientific determination of amount, etc. CONCLUSION: The in-depth study of Chinese patent drugs requires perfecting national drug standards, to developing more rigorous special approval requirements, to establishing the re-evaluation system and to eliminating unsuitable category of Chinese patent drugs.

Objective: To investigate the serum bilirubin level in patients with acute cerebral infarction and its relationship with the prognosis. Methods: A total of 177 patients with acute cerebral infarction (onset ≤2 weeks) were met the diagnostic criteria, 38 patients whose basic information were matched but without acute cerebral infarction (onset >2 weeks), and 102 controls were selected. The serum bilirubin level and direct bilirubin level were detected at 72 hours after admission in all groups, the indirect bilirubin value was calculated, and the biochemical indexes, such as blood lipids, blood glucose, high sensitive C-reactive protein and fibrinogen (FIB) were detected. Neurological deficit in the acute cerebral infarction group was assessed on the day of admission using the National Institutes of Health Stroke Scale (NIHSS). The prognostic evaluation was conducted using the modified Rankin scale (mRs) at 3 months after the onset of stroke. Results: Circled digit oneThe serum bilirubin and direct bilirubin levels in the acute cerebral infarction group were significantly higher than those in the non-acute cerebral infarction group (P < 0.05) and control group or (P < 0.01), and the indirect bilirubin level only higher than that of the non-acute cerebral infarction group (P < 0.05). The mean level of the three kinds of serum bilirubin in the non-acute cerebral infarction group was lower than that in the control group; however, there was no significant difference. Circled digit twoWith the increased severity of neurological deficit in the acute cerebral infarction group, the mean levels of the 3 kinds of bilirubin tended to increase, however, there was no significant difference (P < 0.05). Circled digit threeThree months after the onset, both the serum total bilirubin and direct bilirubin levels at admission in patients with good prognosis (mRs, 0 to 2) in the acute cerebral infarction group were higher than those with poor prognosis (mRs, 3 to 5). The differences were statistically significant (P > 0.05). Circled digit fourMultivariate logistic regression analysis showed that the increased serum total bilirubin level was independently associated with the good prognosis (OR, 0.807, 95% CI: 0.718-0.907. P < 0.01). Conclusion: The serum bilirubin levels showed stressful increase in patients with acute cerebral infarction. The increased serum bilirubin level is not significantly associated with the severity of neurological deficit, but it is associated with good prognosis. The increased serum bilirubin level may be a protective defense response of the body for stroke events.

Objective To explore the factors related with osteoporosis in middle-aged men who accepted high education. Methods 306 men were investigated about their bone density, also their behaviors, diet, exercise and so on. Results The incidence of osteoporosis increased with the aging. The Logistic regression showed that smoking (OR=4.61) and alcohol intake (OR=1.11) were the risk factors for osteoporosis,while the milk intake (OR=0.19) and exercise (OR=0.13) were the protective factors. Conclusion The low bone mass and osteoporosis of middle-aged men accepted high education are associated with the age, smoking, alcohol or milk intake and exercise.

Objective To investigate the changes of cesarean section rate and indications in different level hospitals of different areas in China during 2000 to 2009. Methods Literatures published in Chinese journals on variation of cesarean section rate and indications from 2000 to 2009 were analyzed. Cochran-Armitage test was used to analyze the trend. The differences of cesarean section rate between different areas or different level hospitals were analyzed by chi-square test.Results Forty-nine papers were enrolled in this study.Cesarean section rate had risen from 2000 (32.1％,10 353/32 258) to 2009 (52.5％,3674/6992)(Z=-20.8267,P＜0.01).During 2000 to 2008,the average cesarean section rate of level one grade A hospital was 45.7％ (3754/8214),which was higher than 34.5％(25 015/72 507) in level three grade A hospital and 32.3％(28 140/87 121) in level two grade B hospital (P＜0.05,respectively).Except for level three grade A hospital,cesarean section rate had risen in the other two level hospitals during 2003 to 2008. The average cesarean section rate was 58.6％ (4982/8502) in northeast area during 2000 to 2007,which was higher than that of other areas (P＜0.01); and the average cesarean section rate was 27.5％ (12 264/44 595) in central China and 33.0％ (23 239/70 421) in southern China,which were lower than that of other areas (P＜ 0.01 ). Social factor,instead of dystocia,became the most important indication for cesarean section,and its proportion kept rising annually,from 11.3％ (1170/10 353) in 2000 to 27.1％(2094/7726) in 2008 and remained above 20.0％(5159/24 691) since 2004.The proportion of scar uterus rose from 6.7％(694/10 353) in 2000 to 12.5％ (459/3674) in 2009. Conclusions Cesarean section rate rises fast and its major indications had changed in China. It is suggested that special method should be taken to control the current situation.

BACKGROUND:Docetaxel, a cel cycle specific anti-tumor drug, is a drug that is used primarily for treating breast cancer; however, its efficacy is low when used for treatment of cancer not sensitive to radiotherapy. Bone marrow mesenchymal stemcels have been shown to strengthen the effects of tumor-specific targeting chemotherapy drugs. OBJECTIVE:To investigate the effects of docetaxel combined with bone marrow mesenchymal stem cels (BMSCs) on human hepatoma cel line SMMC-7721. METHODS:BMSC cels were culturedin vitro. The logarithmic growth of SMMC-7721 hepatoma cels were randomly divided into blank control group, BMSCs group and combined treatment group (combined treatment of BMSCs and docetaxel). SMMC-7721 cel cycle was detected usingflow cytometry. Cel growth rate of SMMC-7721 was determined by MTT assay. mRNA and protein expressions of tumor suppressor genes PTEN and p53 were detected by reverse transcription polymerase chain reaction and western blot assay. RESULTS AND CONCLUSION:Combined treatment of docetaxel and BMSCs inhibited SMMC-7721 cell proliferation. Compared with the blank control group, the number of cells at the G0/G1 phase was significantly increased in BMSCs group and combined treatment group. The cell growth rate of SMMC-7721 was significantly inhibited in BMSCs group compared with the blank control group, and that was further inhibited in combined treatment group (P< 0.05). mRNA and protein expressionof PTENandp53 were significantly increased in combined treatment group compared with BMSCs group and blank control group (P< 0.05). Our results suggest that BMSCs inhibit the growth of SMMC-7721 cells,andcombined use of docetaxel and BMSCs strengthensthe antitumor effect of BMSCs.

Objective:To explore the influencing factors of physicians' professionalism,to understand the cognitive status and changes of professional responsibility and put forward the corresponding strategy.Methods:The satisfaction and cognitive status of physicians'professionalism were investigated using the self-designed questionnaire that adapted to medical staff,and the data was analyzed using statistical software SPSS19.0.Results:It showed that the satisfaction with the job itself was quite high.But they thought that the work risk was high,their own value was difficult to realized,and the professionalism was lack of cultivation.Conclusions:It suggests to put forward measures and suggestions from the perspective of system reform,vocational education,hospital culture,social atmosphere,decision-making of doctors and patients together.