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.

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.

Objective To study the short-term clinical efficacy of treating patients with advanced gastrointestinal cancer with lentinan injection and javanica oil emulsion injection.Methods Clinical information of 42 patients with advanced gastrointestinal cancer were retrospectively collected.The 42 patients were divided into two groups according to treatments,with 21 case in the control group who were treated with javanica oil emulsion injection,as well as 21 case in the treatment group treated with lentinan injection and javanica oil emulsion injection.The efficacy,quality of life (QOL) and adverse effects were observed after treatment for 3 weeks.Results 81.0％ (17/21)of patients in the treatment group improved in QOL,which was much higher than that in the control group 47.6％ ( 10/21 ) ( x2 =5.081,P =0.024 ).The objective remission rate was 19.0％ (4/21)and 14.3％ (3/21)in the treatment group and the control group respectively,with no significant differece bwtween the two groups( x2 =0.171,P =0.679 ).the disease control rate was 85.7％ (18/21)in the treatment group,which was significantly higher than that of 61.9％ (12/21)in the control group( x2 =4.200,P =0.040 ).The incidence of adverse effect related to hematological toxicity,liver and kidney function,the digestive tract and itching of skin were similar between the two groups (Ps ＞ 0.05 ).Phlebitis in the treatment group was not as frequent as that in the control group(P ＜0.05).Conclusion Treating patients with advanced gastrointestinal cancer with lentinan injection and javanica oil emulsion injection had high efficacy than treating only with javanica oil emulsion injection,and it improved QOL signifiantly with safety.

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 .

Objective To analyze the relationship between methylenetetrahydrofolate reductase (MTHFR)C677T,A1298C and methionine synthase reductase(MTRR)gene polymorphism with abnormal pregnancy history.Methods 549 normal women (control group)and 300 women with the abnormal pregnancy history(observation group)were taken as the subjects by adopting the case control research method.The oral mucosa epithelial cells were collected for extracting genomic DNA.The MTHFR and MTRR gene polymorphisms were detected by the gene sequencing method.Results The distribution frequency of MTHFR 677TT genotype in the abnormal pregnancy group was significantly increased compared with the control group (10.00% vs.3.46%,χ2 =15.25,P <0.01);the distribution frequency of MTHFR-1298CC genotype in the abnormal pregnancy group was significantly in-creased compared with the control group (11.00 vs.4.01%,χ2 =15.66,P <0.01);the distribution frequency of MTRR A66G gen-otype had no statistical difference between the two groups(χ2 =3.02,P =0.082).The interactive analysis of 2 genes indicated that simultaneous carrying the MTHFR A1298C mutation site and MTRR A66G mutation site increased the possibility of abnormal pregnancy occurrence (OR=1.52,P =0.011).Conclusion MTHFR C677T and A1298C have a certain correlation with female ab-normal pregnancy occurrence.

PcoI-PcoR is a quorum-sensing (QS) system influencing the biofilm formation and rhizosphere colonization in Pseudomonas fluorescens 2P24. The expression of the pcoI, a N-acyl-homoserne lactone (AHL) biosynthase gene, is under the regulation of a number of chromosomal factors, such as the GacS-GacA two-component system. In this paper, we investigated the upstream regulators that influence the transcription of pcoI gene using a chromosomal pcoI-lacZ fusion reporter strain PM203. Cosmids containing genomic DNA of the wild-type strain 2P24 were introduced into the reporter strain PM203 (gacA—, pcoI-lacZ) to screen positive transcriptional regulators of pcoI gene. One of them named pP32-24, which contained a 5-kb Pst I functional fragment was selected. Further analysis identified that the pcoI was the gene responsible for the increase of the pcoI-lacZ expression. The expression of pcoI-lacZ reporter was alsoimproved in both PM101 (pcoI-lacZ) and its gacAmutant PM203 after addition of exogenous AHL, indicating that the expression of pcoI is positively regulated by AHL (autoinduction) in strain 2P24. In addition, deletion mutagenesis and complementation experiments demonstrated that the transcriptional regulator PcoR positively controlled the expression of pcoI and the formation of biofilm. These results suggest that, in strain 2P24, the expression of PcoI-PcoR QS system is auto-inducted, and the transcriptional factor PcoR is involved in the regulation of pcoI transcription and the biofilm formation.