Arterial Occlusive Diseases ; diagnosis ; etiology ; Coronary Disease ; complications ; diagnosis ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged

Objective To explore the impact of transtheoretical model on sun protection behaviors of soldiers in plateau area.Methods A total of 208 male soldiers trained in 4 200 meters altitude and medically supported by our hospital were randomly divided into the experimental group(n=104) and the control group(n=104).The experimental group received health education based on the transtheoretical model,and the control group received routine health education.Score of sun protection behaviors questionnaire,sunscreen using behavior and score of the Dermatology Life Quality Index (DLQI) before and after the intervention between two groups were compared.Results Score of sun protection behaviors questionnaire in the experimental group was higher than that in the control group (P＜0.05),sunscreen using behavior in the experimental group was better than the control group(P＜0.05),score of the Dermatology Life Quality Index in the experimental group was lower than the control group(P＜0.05).Conclusion Health education guided by the transtheoretical model can improve the plateau soldiers' sun protection behaviors,and it is an effective method of health education.

Aim To investigate the anti-proliferative effect of salinomycin on doxorubicin-resistant human breast cancer MCF-7 /DOX cells.Methods MCF-7 and MCF-7 /DOX cells were treated or untreated with salinomycin.Cell viability was detected by MTS assay. Cell apoptosis was detected by Annexin V-FITC /PI as-say.Reactive oxygen species (ROS)was measured by DCFH-DA staining.Mitochondrial membrane potential was measured by JC-1 assay.The expression of apopto-sis related proteins BAX, BCL-2, caspase-3, and caspase-9 were evaluated by Western blot analysis. Results The cell viability was significantly reduced by salinomycin treatment in a dose-dependent manner. The flow cytometry results showed that salinomycin in-duced MCF-7 /DOX cell apoptosis,increased ROS pro-duction,and decreased mitochondrial membrane poten-tial.Furthermore,salinomycin decreased the expres-sion of BCL-2,and increased the expression of BAX, cleaved caspase-3,and cleaved caspase-9.Moreover, the antioxidant N-acetylcysteine (NAC ) markedly blocked the above effects.Conclusions Our results suggest that salinomycin-induced apoptosis in MCF-7 /DOX is associated with induction of ROS production, and activation of mitochondria apoptosis pathway, which may become a potential chemotherapeutic agent for the therapy of doxorubicin resistant breast cancer.

The pathogenesis of pancreatic sinistral portal hypertension (PSPH)is quite different from that of cirrhotic portal hypertension, and PSPH is the only curable type of portal hypertension.Gastric variceal bleeding is a less common manifestation of PSPH;however,it probably exacerbates the patient’s condition and leads to critical illness,and inappropriate management would result in death.Therefore,it is necessary to develop the optimal management of upper gastrointestinal bleeding in PSPH patients.Splenectomy is considered as a definitive procedure,together with surgical procedures to treat underlying pancreatic diseases.For patients in poor conditions or ineligible for surgery, splenic artery coil embolization is a preferable and effective method to stop bleeding before second-stage operation.The therapeutic decision should be made individually,and the further multi-center study to optimize the management of upper gastrointestinal bleeding from PSPH is warranted.

ObjectiveTo investigate the effects of intramuscular Botulinum toxin type A (BTX-A) injection on spasticity of lower limb, walking and activities of daily living (ADL) after stroke. Methods13 patients with spasticity on lower limb were injected intramuscularly with BTX-A, and assessed with Composite Spasticity Scale (CSS), step length and gait velocity, and Barthel index (BI) before and 1, 4, 8 and 12 weeks after treatment. ResultsThe scores of CSS and BI significantly improved after treatment (P<0.05). There was some improvement in step length and gait velocity, but not significant (P>0.05). All the improvement appeared 1 week after injection and lasted to the 12th week. ConclusionLocal intramuscular BTX-A injection can reduce the spasticity on lower limb and improve ADL.

Adult ; Coronary Artery Disease ; complications ; etiology ; Female ; Heart Valve Prosthesis ; adverse effects ; Humans ; Mitral Valve ; surgery ; Myocardial Infarction ; etiology ; Postoperative Complications ; Thromboembolism ; complications ; etiology

Objective To investigate the risk factors for nosocomial infections in rehabilitation department of a general hospital. Methods The infection rate, underlying diseases and infection sites were retrospectively reviewed in 1243 patients hospitalized in rehabilitation department of the Second Affiliated Hospital of Wenzhou Medical College from July 1, 2004 to June 30, 2008. Risk factors were determined by multivariate analysis with Logistic regression. Results The infection rate and the frequency of nosocomial infections in rehabilitation department were 18. 34 % (228/1234) and 21. 40 % (266/1243), respectively. Patients with spinal cord injury and those with cerebrovascular diseases accounted for 41.67% (95/228) and 31. 14% (71/228) of the total nosocomial infections, respectively. Urinary tract and lower respiratory tract were the frequent infection sites. The incidence of nosocomial infections was correlated with underlying diseases, age, length of stay, invasive operation, nutrition, sensory or movement disturbance and dysphagia. Conclusions Rehabilitation department has high nosocomial infection rate. Relevant risk factors should be carefully monitored to prevent or reduce the occurrence of the infections.

BACKGROUND: Chinese medicines have better effects on preventing and treating diabetic nephropathy at early period, and the effects are caused by the diversity of the effective components of Chinese medicines which acts on the different targets of diabetic nephropathy.OBJECTIVE: To observe the effect of Xiaokening on the proliferation of mesangial cells under high glucose, and investigate the possible mechanism. DESIGN: A controlled observation.SETTING: Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University.MATERIALS: The experiments were completed in the Research Room of Cell Culture, Research Center of Endocrine Metabolism, the First Affiliated Hospital of Nanjing Medical University from July 2003 to May 2004. The rat mesangial cell lines HBZY-1 were bought from Chinese Center for Typical Culture Collection.METHODS: The mesangial cells were passaged and cultured according to the instructions. ① Grouping according to different concentration of stimulation: In the high glucose+Xiaokening group, Xiaokening of 6 concentrations were used, I.e., 20.0, 40.0, 60.0, 80.0, 120.0, 200.0 g/L. Meanwhile,normal glucose control group and high glucose control group were also set,the glucose concentration in the medium was 5.6 and 30 mmol/L respectively. The proliferations were observed after 72 hours. Grouping according to different time points of stimulation: There were normal glucose control group, high glucose control group and high glucose+Xiaokening group, the glucose concentration in the medium was 5.6, 30 and 30 mmol/L respectively, and the Xiaokening concentration was 60 g/L. The proliferations were observed at 24, 48 and 72 hours respectively in the three groups.② The dispensed cell suspension was placed into the 96-well plate, and 200 μL suspension for each well. The culture plate was placed in the inoculation box containing CO2 (0.05 in volume fraction) at 37 ℃ for 24 hours, then the supernatant was deserted, cell solutions containing different drugs of different concentrations were added in each group, 200 μL for each well. The 96-well plate was then placed in the culture box containing CO2 (0.05 in volume fraction) and 100% humidity at 37 ℃ for inoculation.In the groups of different concentrations, 20 μL MTT (5 g/L) was added into the wells after 72 hours. In the groups of different time points, 20 μL MTT (5 g/L) was added into the wells at 24, 48 and 72 hours. Then the plates were inoculated at 37 ℃ for 4 hours. Under microscope, it was observed that MTT get into the cells, the supernatant was sucked away, then 150 μL dimathyl sulfoxide was added to dissolve methyl alcohol, and shaken to even with plate rocking bed for 30 s, and the absorbance (A) values were recorded with the microplate reader at the wavelength of 492 nm.MAIN OUTCOME MEASURES: The proliferations of mesangial cells (A value) were observed at different time points and in Xiaokening of different concentrations.RESULTS: ①Proliferation of mesangial cells at different time points: The A values in the high glucose control group at 24, 48 and 72 hours (0.685 ±0.010, 0.750±0.087, 0.659±0.018) were higher than those in the normal glucose control group (0.586±0.054, 0.598±0.040, 0.527±0.047, P ＜ 0.05). In both the high and normal glucose control groups, the A value at 48 hours was higher than that at 24 hours (P ＜ 0.05), but the A value at 72 hours was lower than that at 48 hours (P ＜ 0.05). The A value in the high glucose+Xiaokening group at 72 hours was 0.538±0.023, and it was lower than that in the high glucose control group (P ＜ 0.05). ② Proliferation of mesangial cells in Xiaokening of different concentrations: Xiaokening high er than 60.0 g/L could obviously restrain the excessive stimulation of high glucose to the mesangial cells, and the effect was in a concentration-de pendent manner, but too high concentration (120.0 g/L) would result in the abscission and death of cells, whereas no survived cells could be observed in extremely high concentration (200.0 g/L). CONCLUSION: Xiaokening could inhibit the proliferation of mesan gial cells stimulated by high glucose after 72 hours in a concentration dependent manner, but too high concentration would cause strong cytotoxicity.

Objective To characterize the features of breast mucinous carcinoma on T2WI, dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion weighted imaging (DWI) and correlate the MR features with histopathology. Methods MR imaging in 8 women (aged 33--65 years old) with mncinous carcinoma of the breast verified histopathologically was performed on 1.5 T scanner with T1WI, FS T2 WI, 3D DCE-MRI using volume imaging for breast assessment(VIBRANT) sequence, DWI with b value of 500 and 1000 s/mm2 by single-shot EPI sequence. According to the lexicon of BI-RADS-MRI designed by ACR, the MR findings were retrospectively studied, including morphology, signal intensity on T1WI and FS T2WI, mass enhancement, the patterns of dynamic enhancement curve, and the mean ADC on DWI. The pathologic diagnosis was made according to the standard criteria by the World Health Organization Classification of Tumors. Results Five patients were pure mucinous carcinoma and 3 patients were the mixed. The amount of mucus ranged from 60% to 90%. All 8 tumors presented as a mass on MRI with low signal intensity on T1WI, high or strongly high signal intensity on FS T2WI and high signal on DWI. The tumor size ranged from 1.3 to 3. 2 cm in diameter. Five tumors showed rim enhancement in early phase and the central part was gradually enhanced in delayed phase. One tumor presented slightly heterogeneous enhancement. Two tumors showed progressively heterogeneous enhancement. The mean ADC values of tumor were (2.41±0.28) ×10-3 mm2/s with b value of 500 s/mm2 and (2.06 ±0. 14) × 10-3 mm2/s with b value of 1000 s/mm2, and higher than that of the normal breast tissue [ ( 1.71 ±0. 32) × 10-3 and ( 1.43 ± 0. 24) × 10-3 mm2/s]. Conclusions The MR features of breast mucinous carcinoma on T1WI, DCE-MRI, and DWI are different from that of invasive ductal carcinomas and may reflect its distinct histological type. The combination of these MR sequences may lead to a pre-operative diagnosis of this tumor.

Objective To explore the way to reduce the absorption of irrigating fluid during PCNL. Methods The amount of absorbed fluid during PCNL in 20 cases (13 males and 7 females)was monitored by ethanol method. The average age was 40 years old. The maximum diameter of calculi by average was 25 mm. Heart rate and mean arterial pressure were monitored during operation.Haemoglobin concentration, serum Na+, K+, Cl-, carbon dioxide-combining power and serum creatinine were measured before and after operation. The amount of irrigating fluid, the duration of operation, and the intrapelvic pressure were recorded. Results The absorbed volume of irrigating fluid in 20 cases was from 50. 2 to 685.0 ml. There was no significant difference in heart rate, mean arterial pressure, serum Na+ , K+ , Cl- and serum creatinine between pre-operation and post-operation(P>0.05), but the postoperative haemoglobin concentration (130.4±16.3 g/L) and carbon dioxide-combining power (24.1±3.2 mmol/L) were lower than that before operation( 142.6±15.6 g/L,26.4±2.0 mmol/L), the differences were significant (P<0. 05). The mean volume of absorbed irrigating fluid in patients with the cumutative time of the intrapelvic pressure higher than 30 mm Hg >10 min,the duration of operation >1 h, or the amount of irrigating fluid >10000 ml was 381. 1, 301.6,261.6 ml respectively, which was higher than that in the other cases (142.9, 136.4, 130.2 mi), the differences were significant (P<0.05). Conclusions The ethanol method is simple, convinent,safe, valid, and is suitable for patients with compromised cardiorespiratory or renal function, who are more likely to develop volume overload because of fluid absorption.