Objective To investigate the symptoms of diarrhea and the behavior of medical treatment after diarrhea in 2013 in Tianjin City, and provid background information for the future population monitoring. Methods A stratified sam?pling method was used to investigate the symptoms, medical treatment and self medication behavior of 4028 residents in Tianjin. Results The number of people who had diarrhea in 2013 was 324, and the incidence rate of diarrhea was 8.04%. Diarrhea was mainly occurred in May-October (n=241, 74.38%). The incidence of diarrhea was the highest in 60-74 years old group, followed by 75-years old and 0-14 years old groups. The incidence of diarrhea was the lowest in 15-29 years old grouop. A total of 121 patients with diarrhea chose to go to hospital (47.08%), 78 patients chose to buy medicine for treat?ment (30.35%) and 58 patients did not do any disposal (22.57%). Among the patients with diarrhea, the highest proportion of patients chose to go to the first grade and the following medical institutions (68.59%, 83/121). There were 14.05%(17/121) and 17.36%(21/121) patients chose to go to the second and the third levels of medical institutions for the treatment. The av?erage cost for patients with diarrhea was 60 (20, 200) yuan. The purchasing expenditure median was 20 (11,50) yuan. The medical spending was more than the purchase of medicines (Z=2.412, P<0.05). The average cost of medical treatment was more higher in the second and the third levels of medical institutions than that of the first medical institution ( Z=50.709,P<0.05). The average cost of medical treatment was in turn increased for patients with diarrhea treated in Baodi county, Xiqing county, Hangu county and Heping county (Z=74.282,P<0.05). There was no statistical significance in medical expenses be?tween patients with different ages and patient with or without medical insurance. Conclusion There are high incidence of diarrhea in patients under 15 years old and patients over 60 years old. Residents suffering from diarrhea mainly choose their own medicine and the treatment in the first and following medical institutions.

AIM: To evaluate the therapeutic efficacy of intratracheal instillation of porcine pulmonary surfactant(PPS) in rats with lipopolysaccharides(LPS)-induced early-stage ALI in this study.METHODS: SD rats weighing 200 g-300 g were randomly divided into 4 groups: LPS(1.5 mg?kg-1)+saline,LPS+PPS 100 mg?kg-1,LPS+PPS 150 mg?kg-1,LPS+PPS 200 mg?kg-1.The PaO2 and PaCO2,as well as survival rate of rats were examined for 6 h after the start of PPS-instillation.Then,rats were killed and lungs were immediately removed for lung index(LI) and histological analysis.The bronchoalveolar lavage fluid(BALF) was collected for measurement of total protein(TP) contents,TNF-? level and white blood cell(WBC) numbers.RESULTS: Significantly increased PaO2,reduced mortality rate,decreased total protein and TNF-? contents in BAL,as well as lung index and meliorated histological appearance were observed in three PPS-treated groups compared with group given saline after LPS(P

Antineoplastic Agents ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Humans ; Interferon-alpha ; therapeutic use ; Liver Neoplasms ; drug therapy ; pathology ; Neoplasm Recurrence, Local ; drug therapy ; prevention & control

BACKGROUND:Insufficient oral soft tissues in the implant zone may have a negative effect on the wound healing and the aesthetic restoration in the late stage. Platelet-rich fibrin can promote the wound healing of soft tissue defects. But there is stil a lack of in-depth studies on the promotion of oral soft tissue defects in animal experiments.
OBJECTIVE: To compare the repairing effects of platelet-rich fibrin and colagen membrane on soft tissue defects of the hard palate in New Zealand rabbits.
METHODS:Fifty-four New Zealand rabbits were randomly divided into three groups (n=14 per group): platelet-rich fibrin group, colagen membrane group and blank control group. A 5 mm-diameter circular ful-thickness soft tissue defect was made in the front of the hard palate, 2 mm distant to the rear maxilary incisors and mucosal edge of the bilateral hard palates. Autologous platelet-rich fibrin membrane or colagen membrane were implanted into the defect in the platelet-rich fibrin group and colagen membrane group, respectively. No treatment was given in the blank control group. General observation of the wound and wound healing analysis were performed at days 3, 7, 14, 21, 28, 56 post operation. Hematoxylin-eosin staining, CD31 immunohistochemical staining and Masson staining were used to observe inflammatory reaction, angiogenesis and colagen formation in the surgical site.
RESULTS AND CONCLUSION:The wound healing rate was fastest in the platelet-rich fibrin group, and no obvious scar formed. At 3 days post operation, there was no difference in the wound healing rates among the three groups; at 7 days, the wound healing rate in the platelet-rich fibrin group was significantly higher than that in the colagen membrane group and blank control group (P < 0.05). At 3 and 7 days after operation, the inflammatory reaction in the platelet-rich fibrin group was less than that in the colagen membrane and blank control groups (P < 0.05); at 14, 21, 28 and 56 days, there was no significant difference between the three groups. At 7, 14, 21 days after operation, the average absorbance value of CD31 in the platelet-rich fibrin group was significantly higher than that in the colagen membrane and blank control groups (P < 0.05). The average absorbance value of colagen formation in the platelet-rich fibrin group was significantly higher than that in the colagen membrane and blank control groups at 7 days after operation (P < 0.05), significantly higher than that in the blank control group at 14 days (P < 0.05), but lower than that in the colagen membrane and blank control groups at 21, 28 and 56 days after operation (P < 0.05). These findings show that platelet-rich fibrin can reduce inflammatory reactions in the process of wound healing, accelerate the angiogenesis, regulate the metabolism of colagen, reduce the formation of scar and improve the quality of wound healing, thereby promoting the repair of oral soft tissue defects.

Objective To summarize and analyze clinical diagnosis and surgical treatment methods of 11 cases with congenital coronary arterial fistula (CCAF). Methods The clinical data of 11 patients who were definited by ultrasonic cardiogram, CT angiography (CTA) and coronary angiography were analyzed retrospectively. Four cases were simple CCAF, 7 cases coexisted with other heart abnormalities. Six cases were given surgical closure of fistula without cardiopulmonary bypass. One of the cases adopted coronary artery under the tangent cotton-padded mattress suture, and 4 cases fistula arterial were ligatured directly. Six cases were given surgical closure of fistula under cardiopulmonary bypass. The right coronary arterial was opened in three of the cases with right coronary artery aneurysm to close fistula. The chambers of heart in the others were opened to close fistula. Results All patients received surgical treatment successfully, and no death happened during the operation. The ultrasonic cardiography showed that all patients recovered well. Follow-up was conducted on 10 patients with the time period ranging from 3 months to 5 years. There was no death and no complication. Conclusions Combined application of ultrasonic cardiogram, coronary angiography and CTA increases the accuracy rate of diagnosis greatly and offers visual bases to formulate operation plan. Surgical operation is quite effective for congenital coronary arterial fistula after definite diagnosis. Operator should try to reserve the expanded coronary arterial, strengthen the anticoagulant after opeation to prevent thrombosis.

Objective To characterize the clinical,electrophysiology and neuropathological features of 4 cases with immune-mediated necrotizing myopathy (IMNM).Methods We retrospectively analyzed the clinical,electrophysiology,neuropathological characteristics of 4 IMNM patients with muscular and skin biopsy in our department during 4 years (from January 2011 to January 2014).Results Among these 4 patients,2 were men and 2 were women (aged 37 to 58 years) with disease duration ranging from 1 month to 60 months.Two patients were with acute onset and 2 with chronic onset.All 4 patients had proximal muscle weakness with three patients with cervical flexor muscle weakness and one with respiratory muscles weakness and noninvasive ventilator assisted respiration.One patient had interstitial lung disease.The anti-signal recognition particle antibodies were strong positive in all 4 patients.Muscle biopsy showed group necrotizing and regenerating fibers in one patient and few scattered necrotizing and regenerating fibers in the other 3 patients.Both muscle fiber hypertrophy and muscle fiber atrophy together with proliferation of connective tissue on endomysium could be viewed in all 4 patients.However,very few inflammatory cells were detectable in patients.One patient was treated with corticosteroids and the other three were treated with combination of corticosteroids and immunosuppressant drugs.Conclusions IMNM is characterized by heterogeneity at disease onset,severity and ilnvolvement of muscles with,however,similary pathological changes including the presence of numerous necrotic and regenerating fibers with little or none inflammation.Corticosteroid and/or immunosuppressant is effective for patients.

BACKGROUND: The existence of minimal residual leukemia cells is the main cause for the recurrence of acute leukemia in children, and immunological biological therapy has attracted more and more attentions in the various methods from eliminating minimal residual disease. Previous studies have found that interferon α-2b can effectively inhibit the increase of tumor cells in vivo in children with neuroblastoma and malignant lymphoma, whether it can inhibit the increase of leukemia cells?OBJECTIVE: To investigate the effects of interferon α-2b in vitro on leukemia cells.DESIGN: A comparative observation taking human promyelocytic leukemia HL-60 cell line as the material.SETTING: Cell Culture Room; Immunological Laboratory; Cell Room, Institute of Pediatrics, Affiliated Hospital,Medical College of Qingdao University.MATERIALS: HL-60 cell line was provided by Shandong Institute of Basic Medical Sciences. Interferon α-2b was purchased from Megagene Company Fluorescein isothiocyanate (FTTC) rabbit-anti-rat Ig solution (CatEK001) and CD13 anti-human monoclonal antibody solution (Cat. DK013Y) were purchased from Union Stem Cell & Gene Engineering Co.,Ltd.METHODS: The experiments were carried out in the Institute of Pediatrics, Affiliated Hospital, Medical College of Qingdao University from March to September 2005. HL-60 cells culture system was established in vitro, and the oncentration was adjusted to 1×109 L-1. The cells were divided into control group and experimental group. In the experimental group, each well was added by interferon-α-2b with the terminal concentration of 5×105, 1×106, 2×106,5×106 and 1×107 U/L, respectively. In the control group, each well was added by saline of the same volume. The cells were cultured continuously for 48 hours. The morphological changes of HL-60 cells were observed using Wright's staining under light microscope; Cell apoptosis was observed using acridine orange/ethidium bromide double staining; Antigen expression and maturation and differentiation on cell membrane were observed by determining CD13 protein expression; Proliferation and activity of HL-60 were detected with methyl-thiazol-tetrazolium (MTT) assay.MAIN OUTCOME MEASURES: The occurrence of apoptosis was judged according to the uniformity and staining of HL-60 nuclear chromatin; HL-60 cell proliferation was judged according to the absorbance (A) value; The maturation of HL-60 cells was judged according to the number of positive CD13 cells.RESULTS: ① HL-60 cell apoptosis: The cells were cultured for 48 hours. When the concentration of interferon α-2b was 5×105 U/L, there were mainly early apoptotic HL-60 cells; When the concentration was 1×107 U/L, there were mainly late apoptotic cells, and the apoptotic rate was significantly higher than those in the control group (P ＜ 0.01 ).② HL-60 cell proliferation: The A values in the experimental groups treated with interferon α-2b of 2×106 U/L and 1 ×107 U/L were significantly lower than that in the control group (P ＜ 0.01). ③ Maturation of HL-60 cells: The percentages of positive CD13 cells in the experimental groups treated with interferon α-2b of 1 ×106 and 1 ×107 U/L were significantly lower than that in the control group (P ＜ 0.01).CONCLUSION: It is concluded that interferon α-2b can enhance the apoptosis, inhibit the proliferation and promote maturation and differentiation of HL-60 cells.

Objective To study the effect of the intervention mode of MTP on use of antibacterials in upper respiratory infection.Methods Adopt retrospective method to select randomly prescriptions of upper respiratory infection from July to September in 2006 for baseline investigation in Outpatient Clinic of Respiratory Department of the First People's Hospital of the city of Zhuhai in Guangdong province.Then aim physicians was interfered by MTP and investigation of post-interference was carried out after a month.The process of intervention and investigation was carried out repeatedly until June in 2007.The ratio of antibacterials use,injection use percentage and average drug fee was observed in pre/post-interference.Results The ratio of antibacterials use in upper respiratory infection in our hospital was decreased from 81.33% to 0,and the ratio percentage of injection use and average drug fee decreased by 81.69% and 35.47% respectively after four MTP circulations.Conclusion The intervention mode of MTP is feasible and effective on promoting the rational use of antibacterials on upper respiratory infection in Outpatient Clinic of Respiratory Department of our hospital.

Objective To investigate the feasibility and safety of modified percutaneous left atrial appendage occlusion (PLAAO) under transthoracic echocardiographic (TTE) guidance without general anesthesia instead of transesophageal echocardiographic guidance.Methods A total of 14 patients who met the inclusion criteria underwent modified PLAAO guided by TTE instead of TEE without general anesthesia.Regular clinical follow-up observations of PLAAO-related major adverse events were done in the perioperative period.Results All patients were successfully implanted with left atrial appendage occluder device (Watchman) without device-related serious complications.Immediately occlusion success rate was 100％.No major adverse events occurred during hospitalization and follow-up.The mean operation time was 108 ± 22 min(range 75-150 min)and the mean radiation exposure time was 15.8 ± 7.6 min(range 8-32 min).Conclusion Modified PLAAO guided by TTE instead of TEE without general anesthesia may be safe and effective.This method simplifies the operation process and is favorable for PLAAO application.But this modified PLAAO is still needed to be validated in more patients.

Objective To explore the relationship among psychological resilience, self-efficacy and core competence in psychiatric nurses. Methods Totally 237 psychiatric nurses in a psychiatric hospital in Shandong province were recruited and assessed with general information questionnaire, Connor-Davidson Resilience Scale, General Self-Efficacy Scale and Competency Inventory for Registered Nurse. Results The total core competence of psychiatric nurses was (2.59 ± 0.66) points, at a moderate level. Psychological resilience were positively corrected with self- efficacy (r=0.454,P=0.000) and core competence (r=0.647, P=0.000), self-efficacy were positively corrected with core competence (r=0.487, P=0.000). Psychological resilience partially mediate the relationship between self- efficacy and core competence, It′s mediating effect was 44.8%. Conclusions Psychological resilience plays an important role to core competence in psychiatric nurses.Nursing managers should carry out related training, improve the psychological resilience and self-efficacy of psychiatric nurses, and comprehensively improve the level of core competencies.