Objective To investigate the early diagnosis and importance of cesarean section in time.Methods Three cases of AFLP treated in our hospital during the past three years were retrospectively studied with emphasis on symptoms,laboratory findings,maternal complications and the action of well-timed cesarean section.Clinical diagnose was proved by postpartum liver biopsy or autopsy.Results The gestational age at onset of the three multiparae was 35～36 weeks.In the early stage,all cases had malaise,nausea,vomit,loss of appetite and epigastric distress followed by jaundice.Laboratory findings included raised transaminases (≤300IU/L)and total serum bilirubin levels.Neither B ultrasonic nor CT examine found fatty liver.Two of them were received cesarean section after obvious complication,and one died with her baby,the other pulled through MSOF,whose twins died of seriously asphyxia.While the third received cesarean section at early stage and was cured with a healthy baby.Conclusion Increasing awarenessespecially in early piagnosis of AFLP cases and termination pregnancy in time,the prognosis of AFLP is obviously improved.

Objective To investigate the current status about nursing undergraduate students' knowledge,attitude and practice (KAP)regarding nosocomial infection.Methods The self-administered questionnaires were employed to survey 108 undergraduate nursing students on the basis of a simple random sampling method.Results In the knowledge dimension,the nursing students earned 78.3％ of accuracy rate when responding to the questionnaires.The students also demonstrated positive attitudes towards nosocomial infection and occupational safety,particularly the female students.In terms of practice,the students performed relatively poor as 36.1％ of the students were unclear about the classification of medical garbage and 22.2％ of the students used their non-clean hands to touch their eye-glasses.Conclusions The undergraduate nursing students have demonstrated adequate knowledge and proper attitude towards nosocomial infection and occupational safety,however,some behaviors need to be changed.Nursing schools and hospitals should be aware of these findings and provide more training programs regarding nosocomial infection and occupational safety so that they can help students formulate good habits to prevent and control nosocomial infection.

Objective To observe the effect of TGF-β1 on activation and epithelial mesenchymal transition(EMT) in rat hepatic stellate cell-T6.Methods Adopt the MTT method to screen the optimum concentration of TGF-β1 in vitro HSC-T6 cultured.After the HSC-T6 stimulation by TGF-β1 of 10 μg/L for 24 hours, the morphology of the cells was observed under inverted phase contrast microscope, the expression of F-actin which on behalf of cotoskeletal structure was detected by immunofluorescence staining;the expression of α-SMA and N-cadherin,vimentin,E-cadherin was measured by RT-qPCR;The changes of α-SMA,N-cadherin,vimentin and E-cadherin were assessed by Western blot after different concentrations (0,5 and 10 μg/L) of TGF-β1 interventing HSC-T6 for 24 h.Results The optimal cell survival rate was recorded when 10 μg/L TGF-β1 dealt withcells for 24 h.After HSC-T6 were treated with TGF-β1,cells stretched, pseudopodia increased and turn into stellate, cells connections were looser, so that represented a significantly activated state.F-actin filaments gathered to form stress and distributed along the long axis of the cells;The expression of α-SMA mRNA and vimentin mRNA in experimental group was significantly higher while E-cadherin mRNA was obviously lower than the control group(P<0.05).TGF-β1 made the protein expression of α-SMA and N-cadherin, vimentin in dose-dependent increased while E-cadherin was decreased.Conclusions TGF-β1 may induce activation and epithelial-mesenchymal transition of HSC-T6.

Objective To explore and analyze the pathogen proifle and risk factors of infected diabetic foot ulcers, and propose appropriate prevention and intervention measures for early recovery of patients.Methods The data of 120 patients with diabetic foot ulcers treated in our hospital from February 2012 to May 2014 were retrospectively analyzed. These patients were classified into infection group (38 patients) and non-infection group (82 patients) based on whether their ulcer was infected or not. The pathogens and risk factors of infection in diabetic foot ulcer were analyzed.Results In this study, 43 strains of pathogenic bacteria were isolated from 38 cases of infection, of which gram positive bacteria accounted for 51.2 %, gram negative bacteria 41.9 %, and fungi 7.0 %.Staphylococcus aureus,Pseudomonas aeruginosa and Enterobacter cloacae were the top three pathogens, accounting for 16.3 % each. Univariate analysis showed that diabetic vascular complication, retinopathy, more than 2 foci of ulcer, osteomyelitis, and diabetic nephropathy were closely associated with infection (P<0.05). Multivariate logistic regression analysis showed that HDL-C, albumin, diabetic vascular complication, number of ulcers, osteomyelitis were independent risk factors for infection in patients with diabetic foot ulcer. Conclusions HDL-C, red blood cell, hemoglobin, diabetic complications, white blood cell, triglyceride, albumin, diabetic vascular complication and smoking are the risk factors for infection in patients with diabetic foot ulcer. These factors should be prevented and controlled to reduce the incidence of infection in diabetic foot ulcer.

Objective To evaluate the efficacy of Flu/CTX conditioning regimen for the treatment of severe aplastic anemia in pa- tients receiving allogeneic hematopoietic stem cell transplantation. Methods Nine patients with severe aplastic anemia received HLA identi- cal peripheral blood hematopoietic stem cell transplantation (PBSCT) using Flu/CTX conditioning regimen, which consisted of fludarbine [30 mg/(m2 d) for5 days (-7 to -3) ], CTX [50mg/(kg d) for4 days(-5 to-2)]. All patients received cyclosporin A (CsA) and mycophenolet mofetil (MMF) for prophylaxis of graft-versus-host disease(GVHD). Results The Fiu/CTX regimen was very well toler- ated, with no severe regimen related toxicity. In all patients, the median days of neutrephil exceeding 0. 5×109/L and platelet exceeding 20 ×109/L were 12 days (range 10-16 days) and 16 days (range 14-19 days), respectively. Complete chimerism was achieved in all pa- tients at one month after PBSCT. Two patients had acute GVHD and one had chronic GVHD. In the 39-month median follow-up duration, all patients were alive in disease-free situation. Conclusion The Flu/CTX conditioning regimen may reduce transplantation-related toxicities and can achieve full chimerism and high long-term disease-free survival. Allogeneic hematopoietic stem cell transplantation using intravenous Fiu/CTX conditioning regimen is a safe and effective treatment method for the patients with severe aplastic anemia.

Objective To evaluate the efficacy and feasibility of Flu/ivBu/Tl" conditioning regimen for the treatment of refractory or relapsed acute non-lymphocytic leukemia in patients receiving allogeneic hematopoietie stem cell transplantation. Methods Seven patients with refractory or relapsed acute non-lymphocytic leukemia received HLA identical peripheral blood hematopoietie stem cell transplantation (PBSCT) following Flu/ivBu/TY conditioning regimen, which consisted of fludarbine, busulfex and thiotepa. All patients received cyclos-porin A (CsA) and mycophenolet mofetil (MMF) for prophylaxis of graft - versus - host disease (GVHD). Results The Flu/IVBu/TT regimen was tolerated very well, without severe regimen related toxicity. In the 31-month median follow-up duration, 5 of 7 patients were a-live in disease-free situation. Conclusion The Flu/ivBu/TT conditioning regimen reduced transplantation-related toxicities and offered high long-term disease-free survival, and was tolerated very well. Allogeneie hematopoietie stem cell transplantation using Flu/ivBu/TT condition-ing regimen is a safe and effective option for the patients with refractory/relapsed acute non-lymphocytic leukemia.

Objective To summarize preliminary experiences on complete video-assisted thoracoscopes lobectomy for patients with non-small cell lung cancer.Methods From October 2009 to March 2012,42 patients with non-small cell lung cancer were treated with complete video-assisted thoracoscopes lobectomy.Tumors located in the left upper lobectomy in 7 cases,10 cases of left lower lobectomy,9 cases of upper right lung,4 cases of right lung,12 cases of lower right lobectomy.Preoperative cTNM stage was Ⅰ-Ⅱ (T1N0M0-T2N1M0),the size of tumor was ＜ 5 cm,no obvious lung and mediastinal lymph node enlargement or pleura hypertrophy.Results All operations were successful.There were (9.5 ± 3.2) pieces of lymph nodes removed.Nz lymph node cleaning was more than 3 groups,the average was 3.3 groups.The operation time was 100-400 (220 ± 37) min,blood loss was 120-700 (150 ± 63) ml,duration of drainage was 3-12(4.5 ± 2.1) d.The postoperative hospital stay was 9-31 (12.2 ± 5.0) d.Conclusion Video-assisted thoracoscopes lobectomy is technically feasible and safe,but the operation indications should be paid special attention.

Objective To investigate the level and value of serum IgE, anti-IgE, FcεRⅠα, anti-FcεRⅠin autoimmune liver disease ( AILD) .Methods In this case-control study, the serum samples and clinical data of 77 patients with hepatosis were collected between May and November 2014 from the department of gastroenterology of Shanghai First People′s Hospital.These patients had positive results about the liver-related autoimmune antibodies, including 33 cases of AILD, 44 cases of other chronic liver disease. 64 healthy persons were collected as control group.Serum mast cell-associated anti-IgE, FcεRⅠα, anti-FcεRⅠwere detected by Enzyme-linked Immuno sorbent Assay ( ELISA) .Serum IgE, IgM and IgG were detected by rate scatter nephelometry.Differences among AILD, other chronic liver disease and healthy control were assessed.Results were compared using Mann-Whitney U test.Results Mast cell-associated anti-IgE, FcεRⅠα, anti-FcεRⅠin liver-related autoimmune antibodies positive patients were significantly higher than healthy control [1.74(1.16 -2.88)mg/L, 14.86(4.39 -26.23)mg/L, 47.22(36.89 -55.29)mg/L and 1.23(0.95-1.58)mg/L, 1.87(1.52-2.33)mg/L, 35.40(24.74-44.89)mg/L, respectively;U=1614,556.5,1319.5, P<0.01].FcεRⅠαwas significantly higher in other chronic liver disease patients than AILD patients [18.40(7.35-30.64)mg/L and 6.25(2.49-22.29), respectively;U=445, P<0.01] .Conclusion Mast cell-associated anti-IgE, FcεRⅠα, anti-FcεRⅠwere increased in liver-related autoimmune antibodies positive hepatosis patients.However, FcεRⅠαwas lower in AILD than other chronic liver disease.Mast cell-associated anti-IgE、FcεRⅠαand anti-FcεRⅠ molecules involved in the inflammatory lesion of liver disease.

Objective To analysis the activity of transcriptional factors in endometrial cancer cell lines with different estrogen receptor subtypes. Methods The mRNA levels of estrogen receptor (ER) was detected by quantitative RT-PCR , and the activity of transcriptional factors was also analysed by 345-channel protein/DNA array in RL-952 ( the expression status of ERα and ERβ both positive), HEC-1A [ERα(±),while ERβ negative] and HEC-1B (ERα and ERβ both negative). The transcription factors of NFkBp65 and p38MAPK with different activity were tested by enzyme-linked immunosorbent assay(ELISA) to confirm the results of protein/DNA array. Results The mRNA levels of ERα in RL-952, HEC-1A and HEC-1B were (6780±282 ), ( 684±84 ) and ( 168±38 ) eopy/ng, respectively. Among 345 candidate transcriptional factors, there were 28 factors associated with ER status. Compared with RL-952 cells, 13 transcriptional activity factors were concomitandy up-regulation, while 15 concomitantly down-regulation in HEC-1A and HEC-1B cells. Transcriptional activities of TrF (1)-1, NRF-1, TCE were significantly correlated with the high-expression status of ERα mRNA ( r =0.523, P=0.037 ), while RFX123 and Ikaros were signitleanfly correlated with the low-expression status of ERα mRNA ( r=-0.312, P=0.041 ). Conclusion Transcriptional factors of TTF(1)-1, NBF-1, TCE may be associated with ER-mediated signal pathway, while RFX123 and Ikaros may be associated with non ER-mediatecl signal pathway in endometrial cancer.

The changes of intracoronary electrocardiogram (IC-ECG) and surface electro-cardiogram (S-ECG) were recorded simultaneously during percutaneous transluminal coronary angioplasty(PTCA) in 33 cases of coronary heart diseases with 41 vessel lesions. The results sug-gested that ST-segment change rate on IC-ECG(90. 2%) was higher than that on S-ECG(56%). ST-segment elevation on IC-ECG was earlier and more significant than that on S-ECG. The IC-ECG appeared to be more sensitive than S-ECG for detecting myocardial ischemia. The technique for recording IC-ECG is simple and it can help to perfome the PTCA successfully.