Objective Intestinal obstruction is a frequent sequela of recurrent ovarian cancer and difficult to deal with We analyzed a series of such patients to determine if their outcomes have changed after undergoing palliative surgery Method We retrospectively reviewed 67 patients undergoing surgery for intestinal obstruction due to recurrent ovarian carcinoma and 75 patients receiving non surgical treatmen from 1997 to 2002 Results During the study period,67 operations were performed on 67 patients Among them,surgical procedure was completed in 58 cases Successful palliation was achieved in 64 2% of cases in which surgical correction was possible The median survival of the entire cohort was 7 8 months,and 12 6 months for the surgically successfully relieved patients and 3 7 months for those non surgical patients The rate of major surgical morbidities was 22 4 % The perioperative mortality rate was 6 0% Successful palliation was associated with the absence of two prognostic factors:multiple obstructive sites and palpable abdominal and pelvic masses Conclusion Palliative surgery for bowel obstruction in recurrent ovarian cancer can be worthwhile,and properly selected patients are the key to its success

OBJECTIVE:To observe the clinical efficacy of Danhong injection and its impact on plsma levels of TNF-? and IL-6 in patients with acute cerebral infarction.METHODS:80 patients with acute cerebral infarction were randomly divided into two groups: 40 in control group were treated with conventional therapy, while the other 40 in treatment group with conventional therapy in combination with Danhong injection.The changes of neurologic function score(NIHSS), clinical effect and the plasma levels of TNF-? and IL-6 after 2-week treatment were compared between the two groups. RESULTS: There were signficnant differences in neurologic impairment score(NIHSS), clinical effect and the plasma levels of TNF-? and IL-6 between the treatment group and the control group after treatment (P

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

OBJECTIVE To investigate the distribution and resistance of clinical isolates to antimicrobial agents commonly used.Antimicrobial agents should be used rationally based on the results of susceptibility testing.METHODS The clinical isolates were identified with W/A-40 or VITEK-32.The results were analyzed by WHONET 5.3 software according to CLSI 2005.RESULTS A total of 2892 clinical isolates were collected in 2007.Gram-negative bacilli accounted for 68.2% and Gram-positive cocci accounted for 31.8%.The top eight pathogens were Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp,Acinetobacter spp,coagulase-negative Staphylococcus,Enterobacter spp,Serratia spp and S.aureus.About 76.4% of S.aureus isolates were MRSA,81.6% of coagulase-negative Staphylococcus isolates were meticillin-resistant.Under 20.0% of Enterobacteriaceae strains were resistant to cefoperazone/sulbactam,imipenem and piperacillin/tazobactam.About 16.3% and 32.5% of P.aeruginosa isolates were resistant to cefoperazone/sulbactam and imipenem.CONCLUSIONS Gram-negative bacilli were dominant isolates in our hospital during 2007.P.aeruginosa is the most frequent pathogenwith severe antibiotic resistance.Enterobacteriaceae are susceptible to cefoperazone/sulbactam and imipenem.

Objective To discuss the video-urodynamic characteristics and management in infra-sacral cord injured patients. Methods The video-urodynamic finding and managements in 169 patients was reviewed. They were followed up for 2 years. Results Detrusor areflexia was found in 76.33% (129/169) patients, among them there were 27.22% (46/169) patients appeared hyper-compliance, and 7.10% (12/169) patients appeared reflux. The video-urodynamic characteristics showed over activity and low-compliance in 12.43% (21/169) patients, including reflux in 5 cases. Different management was chosen according to the video-urodynamic examination. No special complication was observed after 2 years follow-up. Conclusion The majority patients with infra-sacral cord injury appeared detrusor areflexia and hyper-compliance. Special management according to the video-urodynamic characteristics is important for protecting upper urinary tract and preventing urinary system infection.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Silicosis ; diagnostic imaging ; Tomography, Spiral Computed

Objectives To investigate the risk factors of acute renal injury (acute kidney injury) in patients with acute left heart failure.Methods Clinical data of 188 patients with acute left heart failure who were admitted to our hospital were retrospectively analyzed.Logistic regression analysis was used to assess the risk factors for AKI.Results Among 188 patients with acute left heart failure,incidence of acute kidney injury was 33.51％.Univariate and Multivariable logistic regression analyses showed that the independent predictors of acute kidney injury were lower baseline eGFR (OR=4.294,P ＜ 0.001) and anemia (OR=3.573,P=0.006).Conclusions The incidence of acute left heart failure complicated with AKI was high.Basic state of renal function and anemia were the independent risk factors for AKI.

Objective To investigate the effects of PJ34,a poly ADP-ribose polymerase(PARP)inhibitor,on the expression of matrix metallopro-teinases-9( MMP-9 )and Claudin-5 in ischemic cortex of rats with focal cerebral ischemia-reperfusion(I/R)injury. Methods The focal cerebral ischemia-reperfusion model of middle cerebral artery occlusion(MCAO)was established by intraluminal suture . PJ34 was injected intraperitoneal-ly. Blood-brain barrier(BBB)permeability was quantitatively determined by Evans blue assay. Infarct volume changes were observed by 2,3,5-tri-phenyltetrazolium chloridedyeing(TTC)staining. The expression of the MMP-9 and Claudin-5 in rats of cerebral cortex were measured by immuno-histochemistry assay and western blot analysis . Results Compared with sham group,the expression of MMP-9,the contents of EB and infarct vol-ume increased progressively over time after I/R,and reached maximum levels at 48 h(P<0.05);The expression of Claudin-5,the contents of EB and infarct volume reduced significantly over time after I/R,and reached the minimum levels at 48 h in model group(P<0.05). Compared with model group,the expression of MMP-9,the contents of EB and infarct volume was reduced significantly and the expression of Claudin-5,the con-tents of EB and infarct volume was increased at the same time point in PJ34 group(P<0.05). Conclusion PJ34 maintained the blood-brain barri-er permeability by inhibiting the expression of MMP-9,and increasing the expression of Claudin-5,which had neuroprotection on cerebral ischemia-reperfusion injury.

Objective To investigate the effects of Tannic acid on the proliferation of human colon cancer SW 620 cell line and the mRNA and protein levels of TMEM16A .Methods Human colon cancer cell line SW620 were divided into the low dose(50 μmol/L) ,high dose(100 μmol/L) ,they were cultured for 48 h or 72 h separately .Control groups were cultured in the medium with DMSO .The proliferation of SW620 cell line was detected by the MTT assay at different time points (48 h or 72 h) .The cell cycle and apoptosis in the Tannic acid-treated groups were detected by flow cytometry .RT-PCR and Western blotting were used to de-termine the mRNA and protein levels of TMEM16A separately .All data were analyzed using the one-way analysis of variance (ANOVA) ,SNK test by the SPSS software .Results Compared with the control group ,the proliferation of SW620 cell line was significantly inhibited after the treatment by Tannic acid at the concentration of 50 μmol/L and 100 μmol/L for 48 h or 72 h(t=15 .35 ,P<0 .01 ;t=22 .32 ,P<0 .01) .Determined by flow cytometry ,after treated with Tannic acid ,the numbers of SW620 cells were inhibited in the G0/G1 phase and the S phase(F=6 782 .1 ,1 509 .3 ,P<0 .01) ,and the numbers of SW620 cells in G2/M phase were not varied in each group(F=1 .37 ,P>0 .05) ,and increased apoptotic rate when compared with control group (F=545 .3 ,P<0 .01) .The value of 3H-TdR and 3H-Leucine incorporation of SW620 cells treated with Tannic acid(100 μmol/L) 48 h and 72 h separately ,were obviously decreased as compared with that of control group (P<0 .05) .In the low dose treated groups (50 μmol/L) ,the mRNA levels in 48 h group and 72 h group were(0 .633 ± 0 .009) and(0 .621 ± 0 .011) ,and in the high dose treated groups (100 μmol/L) ,the mRNA levels in 48 h group(0 .64 ± 0 .15) and 72 h group(0 .63 ± 0 .11) ,were lower than the control group(F=7 .645 ,P< 0 .05) .After treating SW620 with Tannic acid for 48 h and 72 h ,in the low dose groups ,the protein expression of TMEM16A were(0 .68 ± 0 .14) and(0 .65 ± 0 .12) ,and in the high dose groups ,the protein expression of TMEM16A were(0 .64 ± 0 .15) and(0 .63 ± 0 .11) were decreased when compared with the control group (1 .28 ± 0 .06)(F=4 .508 ,P<0 .05) .Conclusion Tannic acid arrested SW620 at G1-S phase and decrease the mRNA and protein expression of TMEM16A .

To investigate the clinical improvement of limping gait in patients with ankylotic hips and limb length discrepancy.Methods:From 1996 to 2005,12 patients with ankylotic hips and limb length discrepancy were treated by distraction osteogenesis with a mono-lateral external fixator and an intramedullary nail.The limb length discrepancy was 6.20-12.50 (median 8.45) cm.Limping gait was classified according to the recommendations of the American Academy of Orthopedic Surgeons/Hip Society and scored according to Harris:no limping scored 11 points,mild limping scored 8 points,moderate limping scored 5 points,while severe limping scored 0 points.Limping gait was severe in all patients pre-operatively and the total score was 0.Results:All patients were followed up for 30.00-46.00 (median 38.55) months,and all reported improvement in limping gait.The gain in length was 6.00-12.50 (median 8.20) cm,and the mean residual limb length discrepancy was 0-0.50 (median 0.20) cm.The total treatment time was 41.00-82.00 (median 61.50) weeks,the lengthening time was 14.00-38.00 (median 29.55) weeks.At the last follow-up,10patients had mild limping gait and 2 had moderate limping gait; the total score was 90.00.The median score was 7.50 (P25 was 8.00,P75 was 8.00).According to Wilcoxon signed rank test,the post-operative limping gait scores were significantly higher than pre-operative (P=0.001 ).Conclusion:Femoral lengthening can improve the limping gait significantly in ankylotic hips and limb length discrepancy.