Objective To explore the different mechanisms of to cisplatin (CDDP) resistance in human epithelial ovarian cancer cell lines by two different methods. Methods Two resistant cell lines were established: SKOV3/CDDP-P and SKOV3/CDDP-80. They were induced from epithelial ovarian cancer cell line SKOV3 respectively by pulse and intermittent exposures to cisplatin during the period of 16 months. The biological characteristics of all the cell lines were determined using light microscopy and cell counting. Drug sensitivity was monitored by MTT assay. The cell cycle was examined by flow cytometry. The mRNA expression of MDR1,MRP1,LRP1 and GST-? was determined by RT-PCR. Results The resistance indexes of SKOV3/CDDP-P and SKOV3/CDDP-80 were 4.12?2.01 and 11.50?3.15,respectively. Both the two resistant cell lines had some changes in biological characteristics in which SKOV3/CDDP-80 showed more distinct changes. The expression of MDR1 was up-regulated,and the expression of MRP1 and LRP1 was down-regulated,and the expression of GST-? showed no significant changes inSKOV3/CDDP-P. However,SKOV3/CDDP-80 showed a great increases in MDR1,and there was no significant changes in MRP1,LRP1 and GST-?. Conclusion The results suggest that there are many differences between the two resistant cell lines which involved in multi-gene changes. The intermittent administration has greater trend to develop resistance.

Objective To explore the new approach of operatively treating internal rectal mucosal prolapse. Methods 42 patients with internal rectal mucosal prolapse were treated with circular stapling procedure, and followed-up for 2～24 months after operation. Results Mean operative time circular stapling procedure was 18 minutes, and mean hospitalization time of the patients was 3 days. The clinical symptoms were obviously improved after operation. Anastomotic stoma bleeding was found in 9 patients (21.4 %) during operation. Urinary retension was found in 17 patients (40.5%), who needed catheterization. Sensation of rectal tenesmus occurred in 6 patients(14.3%). Infection, anal incontinence and rectovaginal fistula were not found in all the patients. Conclusion Circular stapling procedure is safe, simple and effective technique for treating internal rectal mucosal prolapse with the advantages of minimal invasion.

Objective To analyze the clinical and radiological features of retroperitoneal fibrosis (RPF), and to deepen the understanding of this unusual disease and improve the diagnostic level at the early stage. Methods Fourteen cases (10 males and 4 females, mean age 45.8 years) of pathologically diagnosed RPF from January 1990 to June 2004 were summarized. The clinical and radiological performance of the cases were analyzed. All patients received non-contrast CT scanning, 10 of them underwent enhanced CT scanning as well. 8 patients received MRI, 10 patients received IVP examination, and 11 received B-ultrasound. Results (1)The very first symptoms usually included back pain, bellyache (10 cases), or urinary tract obstruction (3 cases), with increase of ESR, IgG, CRP value and abnormal renal function.(2)The result of radiological examination showed that 11 lesions of the 14 cases located at retroperitoneum. Ten cases were mass type and 4 cases were diffuse type. Non-contrast CT scanning revealed soft tissue mass at retroperitoneum with inhomogenous or homogenous density. After contrast medium injection the lesions were enhanced with different extent. MRI results showed that the lesions presented low signal in T_1WI, while in T_2WI the signals had no obvious coherence but were different from one case to another. Conclusion Radiological examination is one of the important methods for diagnosis of RPF. Based on the different characteristics of RPF in CT and MRI, together with the clinical findings, we will get valuable references for staging and follow-up of RPF.

Adenine ; analogs & derivatives ; Hepatitis B, Chronic ; Humans ; Organophosphonates ; Tenofovir ; Treatment Failure

Objective To compare the effect of treating hyperglycemia on insulin pump therapy in newly diagnosed type 2 diabetes mellitus(T2DM) and the patients with failure to oral antidiabetic therapy. Methods Selecting 32 patients with newly diagnosed T2DM(NDM group)and 64 T2DM patients with failure to oral antidiabetic therapy(ODM group),which were treated by insulin pump,having no significant difference of the level of blood glucose,body mass index(BMI),age,proportion of sex between NDM group and ODM group. Results (1)The mean time and the maximal dosage of insulin for blood glucose to be targeted in NDM group were all lower than those in ODM group(P all

Alongside the social and economic development in China, medical risks, economic risks, and legal risks rise as well in the management of public hospitals. However, the capabilities of these hospitals in prevention and control of medical risks and disposal of legal affairs fall far behind the increasingly complex legal affairs. In this consideration, the authors introduced their innovative practice in taking legal actions for prevention and control of medical risks in the hospital, analyzed the problems found in medical legal affairs, and put forward specific suggestions to promote the standardization and modernization of hospital legal affairs.

Objective To investigate the change of the nutritional status of elderly patients in Chinese major hospitals dynamically with nutritional risk screening 2002 (NRS 2002) and subjective global assessment (SGA) during hospitalization.Methods A prospective,multi-center survey was conducted on over 65 years old patients who were admitted in departments of gastroenterology,respiratory medicine,general surgery,geriatrics,thoracic surgery,neurology,orthopedics and medical oncology of 9 large hospitals in China for 7-30 days between June 2014 and September 2014.On admission and within 24 hours after discharge,the clinical data were recorded,physical indices were measured,and laboratory examination were conducted.NRS 2002 and SGA were used to make an evaluation.The nutritional supports and clinical outcomes were also recorded and then the correlation between nutritional status and clinical outcomes were analyzed.Results A total of 2558 patients above 65 years old were included into the study.Compared with their status on admission,their grip strength,upper arm circumference and crural circumference were reduced significantly at discharge (P＜0.05).The total protein,albumin and hemoglobin levels were significantly lower than those on admission (P＜0.05).The incidence of nutritional risk (NRS 2002 score ≥ 3) and malnutrition (SGA B + C) on admission were lower than those at discharge (51.1％ vs 53.0％,32.6％ vs 35.6％).The hospitalization time and medical expenses were higher in patients with malnutrition on admission than in those with normal nutrition intakes.The nutritional status at discharge was negatively correlated with hospitalization time and medical expenses.61.3％ patients having nutritional risk did not take nutritional support during the hospital stay,while utilization rate of parenteral nutrition was higher than that of enteral nutrition in patients receiving nutritional support (19.6％ vs 11.9％).Conclusion Elderly patients have higher possibilities of facing nutritional risk or malnutrition on admission,these are associated with poor clinical outcomes and their nutritional status will not improve significantly at discharge.Therefore,the screening and evaluation of nutritional status in elderly patients during hospitalization should be conducted and their nutritional intervention should be standardized so as to improve the clinical outcomes.

OBJECTIVE: To analyze the effect of noise exposure on the hearing ability at different frequency in workers.METHODS: A total of 2 411 workers in a mechanical plant in Guangzhou were chosen as the study subjects by using judgment sampling method. The pure tone audiometry threshold test was carried out to analyze the status of hearing loss at different frequencies and its relationship with the length of service of workers. RESULTS: Among the 2 411 workers,883 workers had different degrees of decreased hearing thresholds,the detection rate was 36. 6%. Among them,the single unilateral hearing loss accounted for 19. 6%( 472/2 411),and the binaural hearing loss was 17. 0%( 411/2 411). The hearing loss detection rate of left ear was higher than that of the right ear( P < 0. 05). The decreased threshold of left ear at 0. 5,3. 0 and 6. 0 kHz was higher than that of the right ear at the same frequencies( P < 0. 05). The decreased threshold in both the left and the right ear increased with the increase of the frequency( P < 0. 01). The decreased hearing threshold was the highest at the frequency of 6. 0 kHz. The auditory threshold of left ear in 0. 5,1. 0,2. 0,3. 0 and 6. 0 kHz were higher than that of right ear at the same frequencies( P < 0. 05). The detection rate of hearing loss increased with the increase of service length( P < 0. 01). The decreased threshold of 1. 0-6. 0 kHz increased with the increased length of service except for the frequency of 0. 5 kHz( P < 0. 05). CONCLUSION: There is a significant decreased threshold in workers exposed to noise frequency of 6. 0 kHz. The hearing ability of left ear is more easily impaired than the right ear.There is a dose-response relationship for the length of noise exposure and hearing loss.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.