OBJECTIVE To search for the reasons of unqualified level of bacteria in exit-entrance fluid of hemodialyzer and draft the measures of adjustment to meet the evaluation criteria for exit-entrance fluid of hemodialyzer.METHODS According to MOH′s Hospital Infection Management Standards to detect level and species of bacteria.RESULTS The average numbers of bacteria in exit-entrance fluid of hemodialyzer decreased from 2152.95?826.45 CFU/ml before adjustment to 579?541.04 CFU/ml after adjustment,checking with chi square test,the entrance fluid of hemodialyzer was ?2 =15.92,P

Objective To study the anti-apoptotic effects of Levodopa on osteonecrosis of the femoral head induced by methylprednisolone (MPS).Methods Forty-four rabbits were randomly divided in to 3 groups.The model group (n=15) was injected with lipopolysaccharide (LPS,10 μg/kg) and then MPS (20 mg/kg) was given 3 times with 24 h interval.The treatment group (n=1 5) was firstly treated by the same methods as the model group,then was administered Levodopa (0.4 g·kg~(-1)·d~(-1)) orally after the last injection of MPS.The control group (n=14) was injected with sodium chloride alone.On the 6th and 8th week after modeling,radiography and MR images were taken in 7 rabbits of each group,specimens taken from the femoral heads were observed by HE stain and TUNEL analysis was made.Blood samples were taken for detection of insulin-like growth factor-1 (IGF-1) on the 8th week.Results On the 6th and 8th week,the average percentage of empty osteocyte lacunae in the treatment group (13.33‰±3.06‰,25.97‰±6.29‰) was significantly lower than that of the model group (21.44‰±4.77‰,33.86‰±8.38‰,P<0.01),and the average apoptosis index in the treatment group (74.93‰±14.32‰,120.67‰±13.13‰) was significantly lower than that of the model group (102.56‰±18.96‰,202.02‰±18.99‰.,P<0.01).On the 8th week,the level of IGF-1 in the treatment group was (14.78±2.37)ng/ml,which was higher than that of the model group obviously (10.12±2.49)ng/ml(P<0.01).Conclusion The Levodopa can decrease apoptosis of osteocytes and effectively prevent the progress of steroid-induced osteonecrosis of the femoral head.

Objective To investigate the clinical and pathological characteristics of urocpithelial sarcomatoid carcinoma of the urinary system,and improve the diagnosis and treatment of these tumors.Methods We reviewed the pathology comfirmed urinary system caicinoma at the General Hospital of PLA from January 1999 to December 2010 and analyzed the clinical and pathological data of cases with sarcomatoid carcinoma in them retrospectively according to the literatures. Results A total of 4386 urinary system carcinoma were comfirmed,among them 18 (0.41％) cases of sarcomatoid carcinoma were identified,including 13 from bladder,4 from ureter and 1 multiple neoplasm of pelvis and ureter.The patients,11 males and 7 female,had a median age of 63.3 years (41-84 yrs).Gross hematuria (18 cases) were the main presenting symptoms,3 with flank pain,4 with pollakisuria,urgency and dysuria (urinary irritation symptoms] and 5 with urinary obstruction.The patient with multiple neoplasm of pelvis and ureter received allograft renal transplantation 7 years ago and took anti-rejection drugs all the way after operation.17 patients underwent surgical resection,9 radical cystectomy,5 radical nephroureterectomy,3 partial cystectomy and the remain was biopsy.Tumor size ranged from 2.5 to 12 cm (median,5.6 cm).Microscopically,coexisting high grade urothelial carcinoma was present in all the 18 cases,12 with sarcomatoid differentiation,3 with sarcomatoid and squamous carcinoma differentiation and 3 with sarcomatoid and glandular differentiation.Sarcomatoid component occupied 10 -90 percent.Immunohistochemical testing showed the sarcomatoid cells were positive for cytokeratin (CK) and vimentin.12 patients died of disease 20 days to 42 months (median,5.3 months) postoperatively.3 patients have been surviving with tumor free for 3,3 and 17 months respectinely,and the other 3 was failure to be followed. Conclusions Sarcomatoid carcinoma of the urinary bladder is a highly malignant disease,and the prognosis is very poor.The diagnosis depends on histopathologic and immunohistochemical studies.Early diagnosis and cystectomy or nephroureterectomy together with chemotherapy/radiotherapy may improve the curative effect.

Objective To evaluate the change about the function of pituitary thyroid axis and the role of human chorionic gonadotropin (hCG) on regulation of pituitary thyroid axis in pregnancy Methods The study was designed to provide longitudinal information of parameters of thyroid function and hCG in 74 healthy women during pregnancy and after delivery Serum free triiodothyronine (FT 3), free thyroxin (FT 4), TT 3, TT 4, hCG and thyroid hormone binding globulin (TBG) concentrations were measured with radioimmunoassary and serum TSH concentration with immunoradiometric assay Results (1) The FT 3 and FT 4 values below the reference range were 5 88% and 9 80%, respectively, in third trimester and after delivery, both were 38 10% The serum TSH level below the reference range was 31 25% in first trimester and supranormal were 11 90% after delivery The serum hCG level at all stages of pregnancy was higher than postpartum (2) The serum FT 3 level was significantly higher in first (4 37?0 78) pmol/L and second (4 75?0 90) pmol/L trimesters than postpartum (2 96?0 84) pmol/L, decreased in third trimester (3 94?0 75) pmol/L and the lowest level after delivery The serum FT 4 level was significantly higher in first (14 07?1 44) poml/L and second (12 86?0 84) pmol/L trimesters than postpartum (10 45?1 45) poml/L, decreased in third trimester (11 29?1 00) pmol/L and the lowest level after delivery (3) The serum TSH level was the lowest values in early pregnancy (0 88?0 83) mU/L, showed significant increase in second (1 86?1 04) mU/L and third (1 48?0 90) mU/L trimesters and reached maximal level after delivery (2 82?1 42) mU/L (4) The serum hCG level was the highest in early pregnancy (309 05?320 02) ?g/L, then significant decreased in second (69 11?19 18) ?g/L and third (86 25?44 60) ?g/L trimesters and was the lowest levels after delivery (29 92?20 91) ?g/L (5) A significant negative correlation between TSH and hCG levels and a significant positive correlation between hCG and FT 4 and TT 4/TBG were demonstrated Conclusions (1) hCG may be as role on regulation of pituitary thyroid axis during pregnancy and during certain time of postpartum (2) After delivery, part of women were transient hypothyroxinemia

Objective To study the expression of Survivin in breast carcinoma combined with prognosis of ten-year follow-up.Methods The expression of Survivin was investigated by immunohistochemistry in 60 cases of breast cancer and 20 tumor surrounding tissue.All the cases were performed with prognosis of tenyear follow-up.Results The expression rate of Survivin in breast carcinoma(68.3%)was higher than that in fibroadenoma of bast tissue(25%)(χ2=20.03,P＜0.01).Survivin didn't experss in tumor surrounding tissue.There Was no relationship among the expression of Survivin and the histological differentiation,clinical staging,and lymph node metastasis of breast carcinoma.The expression of Survivin was correlated with the survival years of patients.Conclusion The expression of Survivin was up-regulated in breast carcinoma,which indicated that survivin may play an important role of the genesis and development of breast cancer,but it may play negative correlated with breast carcinoma.

Objective In order to explore the ways of reflecting the dose distribution in the implementation of the of IMRT (intensity modulated radiation therapy),a 2D diode array (2D-DA) was used in verifying the composite dose distribution of IMRT plans in the way of multi-gantry-angle composite (MGAC).Methods IMRT quality assure (QA) plans of 27 patients,based on the 2D-DA and solid water phantom,were designed and verified in two ways of single-gantry-angle composite (SGAC) and MGAC verifications.The comparison and analyzation of the dose distributions of the TPS calculation and the measurement of the 2D-DA were done.Results (1) When the beam central axes were not superposed with the detectors'plane of the 2D-DA,the verification passrate of SGAC and MGAC planar dose distribution of 27 patients'IMRT plan were 94.56%±4.28% and 94.81%±3.80% (the criteria:rvalue,3 ram/3%),respectively.There was no statistical difference between the results of two sets (t =-0.213,P＞0.05).(2) When one of the beam central axes was superposed with the detectors'plane of the 2D-DA,the verification passrate of MGAC planar dose distribution were 79.72%±12.77%.Conclusions Using the 2D-DA with a proper phantom,there was no statistical difference in the SGAC and MGAC verifications of IMRT plans when the beam central axes were not superposed with the detectors'plane.However,the MGAC dose distribution can provide more about the clinical dosimetry,and the errors in the implementation of the of IMRT were easier located.

OBJECTIVE To investigate the nosocomial infection knowledge nurses in graduating class. METHODS 286 nurses of graduating class were investigated by questionnaires. RESULTS The students were lacked of knowledge about nosocomial infection and 61.70% nurses of graduating class had never participated in the training of nosocomial infection knowledge (the average score only 58.67). They were interested in the disinfection and sterilization of infection diseases. And they wanted to get it through clinical infection control group (81.56% students selected this educational methods). CONCLUSIONS It is necessary to strengthen the training and education of nosocomial infection. And adjust the training mode and content according object.

AIM：To investigate the change in myocardial mitochondrial Ca2＋ concentration (［Ca2+］m) and its mechanism in the early stage of severe burn. METHODS：An experimental model of 30%TBSA full-thickness skin scalding was reproduced in rats. ［Ca2+］m, cytosolic Ca2＋ concentration (［Ca2＋］c) and mitochondrial Ca2＋ transport velocity were determined. RESULTS: ① ［Ca2+］m increased evidently at 1st hour postburn, and continuously at 3rd hour, reached the peak at 6th hour postburn, then, it decreased at 12th and 24th hour, but remained in higher level than that of the control. ② There was no significant difference in ［Ca2＋］c between 1st hour postburn and the control, but ［Ca2＋］c increased evidently at 3rd, 6th, 12th, 24th hour postburn. ③ mitochondrial Ca2＋ uptake velocity at 1st hour postburn was higher than that of control, and Ca2＋ release velocity didn't change obviously, but both of them were decreased at 3rd, 6th, 12th, 24th hour postburn. ④ ［Ca2+］m was positive correlated with ［Ca2＋］c after burn, and negative correlated with mitochondrial Ca2＋ release velocity at 3rd, 6th, 12th, 24th hour postburn, respectively. CONCLUSION: There was obvious Ca2＋ overload in myocardial mitochondria after severe burn, the mechanism of which might include ascent of ［Ca2＋］c and disorder of Ca2＋ transport in mitochondria.

ObjectiveTo explore the diagnostic and differential diagnostic points in a patient with rheumatoid arthritis (RA) complicated with fever and pulmonary diseases. MethodsFull clinical analysis was performed for a 55-year old patient with arthritis, fever, and wheeze. ResultsThe clinical pictures of the patient were consistent with those of RA. Computed tomography(CT) revealed interstitial lung diseases and intrapulmonary cavities. Antifungal agents were given experimentally, and the intrapulmonary cavities disappeared finally, thus the patient was diagnosed as RA, concurrently complicated with interstitial lung disease and pulmonary fungal infection. ConclusionThe possibility of pulmonary fungal infection should be considered in RA patients who presented with fever and intrapulmonary cavities.

Objective To investigate the expression of chemokine VCC-1 in hepatocellular carcinoma (HCC).Methods RT-PCR was used to detect the VCC-1 mRNA expressions in 8 HCC cell lines,10 normal liver tissues and 42 HCC tissues.Result In HCC cell lines,the expressions of VCC1 mRNA were high in SUN 398,intermediate in SUN387,SUN449,SUN423,HepG2,PLC5,and low in Hep3B and Huh7.In HCC tissues,the expressions of VCC-1 mRNA could be found in tumor and adjacent tissues.In these 42 tissues,VCC-1 mRNA was highly expressed in 26 specimens of tumor tissues (61％,14.9±7.6 fold) and 16 specimens of adjacent tissues (39％,6.9±5.4 fold).VCC-1 mRNA was up regulated in tumor tissues (P＜0.01).The expression levels of VCC-1 mRNA in 2 specimens were related to tumor differentiation and tumor size (P＜0.05).In the 10 specimens of normal liver tissues,no expression was detected in 8 specimens and light expression in 2 specimens.The expression was lower compared with cell lines,cancer tissues and adjacent tissues (P＜0.01).In 3 cases of recurrence,VCC-1 was highly expressed in cancer tissues (20.1±2.3 fold).In 8 specimenswith tumor thrombosis,5 tissues showed highly expressed VCC-1 (17.3±4.5 fold) while 3 specimens showed low expression.Conclusion VCC-1 plays an important role in HCC,and it may be considered as a potential therapeutic target of HCC.