Objective To observe the clinical efficacy of acupoint sticking plus hot compress by moxa-salt bag in treating constipation after acute cerebral stroke.Method Eighty patients with constipation after cerebral stroke were randomly allocated to a treatment group and a control group by using random number table method according to registration order, 40 cases each. The control group was intervened by acupoint sticking at umbilicus with rawDa Huang (Rheum Officinale), and the treatment group was additionally given hot compress using moxa-salt bag. The treatment was given once a day, for consecutive 3 days in total. The first defecation time, stool shape and defecation sensation were observed in the two groups. The clinical efficacies were compared between the two groups.Result The total effective rate was 90.0％ in the treatment group versus 72.5％ in the control group, and the difference was statistically significant (P<0.05). After the treatment, there was statistically significant difference in comparing the first defecation time between the two groups (P<0.05). After the treatment, the incidence rate of soft stool was 85.0％ and that of hard stool was 15.0％ in the treatment group versus 40.0％ and 60.0％ in the control group, and the differences were statistically significant (P<0.05). The incidence rate of pleasant defecation sensation was 80.0％ and that of difficult defecation was 20.0％ in the treatment group versus 35.0％ and 65.0％ in the control group after the treatment, and the differences were statistically significant (P<0.05).Conclusion Acupoint sticking plus hot compress by moxa-salt bag is an effective method in treating constipation after acute cerebral stroke.

Objective To reinvestigate the value of overnight low-dose dexamethasone suppression test in the diagnosis of Cushing syndrome.Methods Fifty-two patients with Cushing syndrome and 153 patients with simple obesity or essential hypertension in whom Cushing syndrome was excluded were studied retrospectively in order to compare the sensitivity and specificity of different serum cortisol cut-off levels in overnight 1 mg dexamethasone suppression test in the diagnosis of Cushing syndrome.Results The sensitivity of 50% of basal serum cortisol level at 8:00 and of the serum cortisol cut-off levels of 275,200,138,50 nmoL/L at 8:00 after the overnight 1 mg dexamethasone suppression test was 92.3%,92.3%,92.3%,92.3% and 100.0% respectively, and the specificity was 90.8%,98.7%,96.1%,91.5% and 78.4%,respectively.Conclusion The serum cortisol cut-off level of 50 nmol/L in the overnight 1 mg dexamethasone suppression test has very high sensitivity and can be used as a screening test for Cushing syndrome.

ObjectiveTo explore the detection significance of insulin-like growth factor-I(IGF-I),IGF-binding protein-3(IGFBP-3) in children with acute lymphoblastic leukemia(ALL).MethodsSerum samples were obtained from 30 ALL children without any medication;serum control samples were obtained from 30 cases of healthy children.There were no significant differences of body weight,age and sex between 2 groups.All children had no case history of liver,kidney,malnutrition and endocrine system disease.IGF-Ⅰ was determined by radioimmunoassay kit.IGFBP-3 was determined by immunoradiometric kit.The data were analyzed with SPSS 11.0 software.ResultsThe level of IGF-Ⅰ in ALL group [(18.95?4.02)?106 g/L] was significantly lower than that in control group [(34.12?7.86)?106 g/L](t =9.412P

Objective To explore the standard clinical pathway and stratified cost insurance in patients with senile cataract operation. Methods Patients treatment by senile cataract phacoemulsification combined with IOL implantation were selected as research subjects by cluster sample from two hospitals from 2013 to 2014 . Patients were divided into different groups according to the year, chronic diseases, preoperative waiting time. The difference of hospitalization expenses and hospitalization time were compared. Different levels of hospital costs were established by CHAID decision tree used hospitalization cost as target variable. Results The waiting time for operation was 2 days, the total hospitalized time was 5 days and these can be used as reference time in clinical pathway. Patients uninsured or with long waiting time for operation had longer hospitalized time. Chronic disease, terms of payment and waiting time before operation were point factors that effect the hierarchical of decision tree. Conclusion The new standard of clinical path need to adjust constantly. Distinguish different patients condition and pay different clinical path costs.

Objective To study the changes of mRNA and protein expressions of Kras gene in thymic lymphomas induced by ionizing radiation,and to detect the methylation of CpG islands in promoter region of Kras gene,then to investigate the mechanisms for the occurrence of radiation carcinogenesis.Methods The thymic lymphoma models of BALB/c mice were made by X-ray irradiation,then the total RNA was extracted,cDNA was synthesized and the total protein was extracted from both thymic lymphoma tissue and normal thymus tissue;the mRNA and protein expressions of Kras gene in thymic lymphoma tissue and normal thymus tissue were detected by RT-PCR and Western blotting method, and the methylation of CpG islands in promoter region of Kras gene was detected by bisulfite sequencing PCR. Results The mRNA expression level of Kras gene in thymic lymphoma tissue was significantly higher than that in normal thymus tissue(P<0.01).The protein expression level in thymic lymphoma tissue was about 1.41 times higher than that in normal thymus tissue;4 CpG sites were methylated detected by bisulfite sequencing PCR in normal thymus tissue, however, 1 CpG site was methylated in thymic lymphoma tissue,the CpG islands in promoter region of Kras gene were demethylation state in thymic lymphoma. Conclusion Ionizing radiation can cause the changes of mRNA and protein expression levels of Kras gene in thymic lymphoma tissue by demethylation state of Kras gene,eventually lead to the occurrence of tumor;it might be one of the mechanisms for the occurrence of radiation carcinogenesis.

OBJECTIVETo analyze and evaluate the acceptability of mifepristone compatible with misoprostone versus conventional surgical abortion among women under unwanted early pregnancy, so as to help the unexpected pregnant women to choose the satisfactory abortion, and to provide the evidence for clinicians to make a proper clinical decision.

METHODSSix medical databases were searched, including MEDLINE, EMBASE, Cochrane library, CBMdisc, CNKI and VIP, together with twelve journals hand-searched, and references of included studies additionally searched. Two qualified reviewers reviewed the original articles, evaluating qualities of articles, and extracting data independently. After heterogeneity test, the data was pooled using Revman software if capable, or descriptive analysis was applied.

RESULTSIn total, nine original clinical controlled trials were included, containing 3565 cases. Before abortion, more unwanted pregnant women chose the medical abortion because they believed medical abortion was less painful than surgical abortion (OR = 466.51, 95% CI: 91.37 - 2381.88), but medical abortion was less time-consuming than surgical abortion (OR = 0.02, 95% CI: 0.01 - 0.06). After abortion, satisfaction with medical abortion was similar to that with surgical abortion, with insignificant difference (P = 0.89). However, second choice and recommendation rates of medical abortion were much higher than those of surgical abortion with OR and 95% CI as 2.72, 2.13 - 3.47 and 4.19, 2.16 - 11.16, respectively.

CONCLUSIONSMedical abortion was less painful than surgical abortion and the rate of second choice and recommendation to others were all also higher than those of surgical abortion. However, the process of medical abortion was not as quick as surgical abortion but the satifacation of both methods seemed similar. Therefore, the two artificial abortion methods were not recommended to replace each other at the present time.

Abortifacient Agents ; adverse effects ; Abortion, Induced ; adverse effects ; methods ; Choice Behavior ; Controlled Clinical Trials as Topic ; Female ; Humans ; Mifepristone ; Misoprostol ; Pain ; etiology ; Patient Satisfaction ; statistics & numerical data ; Pregnancy ; Pregnancy, Unwanted

Objective To analyze and compare the imaging features of chromophobe cell renal carcinoma(CCRC)with pathologic findings in order to improve the diagnostic accuracy.Methods The data of CT and MRI of 12 patients with CCRC were reviewed retrospectively.Ten patients underwent CT examination,including precontrast scan,the contrast eortieomedullary phase scan and the parenchymal phase scan(one patient without corticomedullary phase scan).Two patients underwent MR examination including precontrast T_1WI,T_2WI and enhanced T_1WI of the corticomedullary phase and the parenchymal phase.Results Four lesions located in left kidney and eight in right kidney.Maximum diameter of lesions ranged from 24 mm to 125 mm,average 56.7 ram.Homogenous density was observed in six lesions of ten on unenhanced CT scan and five lesions had homogenous enhancement on enhanced CT scan,which was due to the less incidence of necrosis,liquefaction and hemorrhage on pathologic findings.Nine Lesions showed hyperdense compared with renal medulla but the density was lower than renal cortex on the corticomedullary phase.The enhanced degree was positively correlated with microvessel density(MVD).All ten lesions became hypodense compared with renal medulla on the parenchymal phase scan.Central stellate scar was found in two big lesions and psudocapsula were observed in four lesions confirmed by pathology.Two patients underwent MRI examination.Compared with medulla,the two lesions showed hyperintense on unenhanced T_1WI and obviously hypointense on unenhaneed T_2WI.The enhancement pattern of them was similar to CT. Conclusion The imaging features of CCRC,such as homogeneity,special enhancement pattern and distinct hypointensity on T_2WI,help to differentiate CCRC from other renal tumors.

Objective To investigate the therapeutic effect of Huangqi Xuming Decoction for Alzheimer's disease(AD)patients with spleen and kidney deficiency syndrome and to explore its possible mechanism.Methods A total of 134 patients with AD of spleen and kidney deficiency type were randomly divided into observation group and control group,with 67 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with Huangqi Xuming Decoction on the basis of treatment for the control group.The course of treatment for the two groups covered 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,Mini-Mental State Examination(MMSE)score,Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-Cog)score and serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),brain-derived neurotrophic factor(BDNF),superoxide dismutase(SOD),interleukin-6(IL-6)and hypersensitive C-reactive protein(Hs-CRP)in the two groups before and after treatment were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 12 weeks of treatment,the total effective rate of the observation group was 89.55％(60/67)and that of the control group was 71.64％(48/67),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the MMSE scores of the patients in the two groups were higher(P＜0.05)and the TCM syndrome scores and ADAS-Cog scores were lower than those before treatment(P＜0.05).The intergroup comparison showed that the increase of the MMSE scores and the decrease of the TCM syndrome scores and ADAS-Cog scores in the observation group were significantly superior to those in the control group(P＜0.05).(3)After treatment,the serum 5-HT,NE,BDNF,and SOD levels of the two groups were higher(P＜0.05)and serum IL-6 and Hs-CRP levels were lower than those before treatment(P＜0.05).The intergroup comparison showed that the increase of serum 5-HT,NE,BDNF,and SOD levels and the decrease of serum IL-6 and Hs-CRP levels in the observation group were significantly superior to those in the control group(P＜0.05).Conclusion For patients with AD of spleen and kidney deficiency type,the application of Huangqi Xuming Decoction based on the conventional western medicine treatment is helpful to relieving the inflammatory response,regulating the imbalance of oxidative stress,promoting the improvement of the patients'abilities of daily living,and enhancing the clinical efficacy.

Objective To reduce the occurrence rate of risk events, and to improve the nursing quality and the ability of risk prevention. Methods The causes of nursing risk events were analyzed, and then the related risk prevention preplan was established. The effects before and after implemcnting the risk prevention were compared. Results There were statistical meanings in the occurrence rate of risk event, the satisfaction rate and the occurrence rate of risk event of night shift between the two groups (P<0.05). In the aspect of the type of risk event, there were statistical meanings in the inappropriate therapy and implement, the inappropriate treatment of doctor's order and the occurrence rate of nonstandard nursing record between the two groups (P<0.05). There was no statistical meaning in the nursing complains and the occurrence rate of accident event (P>0.05). Conclusions Implement of risk prevention preplan can reduce thc occurrence rate of nursing risk event, and improve the nursing quality and the patients' satisfaction rate.

Objective To investigate the 16S rRNA methylase genes and Aminoglycoside modifying enzymes(AMEs)genes in Enterobacter cloacae isolated from the People's Liberation Army 98th Hospital,Huzhou district,Zhejiang province,China.Methods 40 strains of Enterobacter cloacae were isolated from the inpatients between September,2003 and November,2004.5 kinds of 16S rRNA methylase gene (including armA,rmtA,rmtB,rmtC and rmtD)and 9 kinds of AMEs gene[including aac(3)-Ⅰ,aac(3)-Ⅱ,aac(3)-Ⅲ,aac(3)-Ⅳ,aac(6')-Ⅰ b,aac(6')-Ⅱ,ant(3'')-Ⅰ,ant(2'')-Ⅰ and aph(3')-Ⅵ]were analyzed by PCR and verificated by DNA sequencing.Results In 40 strains of Enterobacter cloacae,the positive rates of genes of rmtB,aac(3)-Ⅱ,aac(6')-Ⅰ b,ant(3'')-Ⅰ,ant(2'')-Ⅰ and aph(3')-Ⅵ were 12.5%(5/40),27.5%(11/40),72.5%(29/40),32.5%(13/40),5.0%(2/40)and 5.0%(2/40),respectively.8 kinds of the rest of genes were all tested negative.The total positive rate of AMEs gene was 85.0%(34/40).Among 29 strains of Enterobacter cloacae that the aac(6')-Ⅰ b gene was positive,through PCR and verification by DNA sequencing,7 strains(24.1%)were confirmed to take the aac(6')-Ⅰ b-cr(the GenBank register number:EF375620,EU159121)alone,18 strains(62.1%)were confirmed to take the aac(6')-Ⅰ b-Suzhou(EU085533)alone,3 strains(10.3%)were confirmed to take both aac (6')-Ⅰ b-Suzhou and aac(6')-Ⅰ b-cr while only 1(3.4%)was aac(6')-Ⅰ b(the classical type).Conclusion There was lower positive rate of 16S rRNA methylase gene but very high AMEs genotypes in Enterobacter cloacae isolated from inpatients and the finding of rmtB gene was reported for the first time in the world.At least 5 kinds of AMEs gene existed in Enterobacter cloacae were isolated and they were the new host of both gene of aac(6')-Ⅰ b-cr and aac(6')-Ⅰ b-Suzhou,with aac(6')-Ⅰ b-Suzhou gene was the predominance subtype in aac(6')-Ⅰ b.