Adult ; Cerebrospinal Fluid Rhinorrhea ; Female ; Humans ; Sphenoid Sinus ; pathology

Objective To investigate the effects of hypoxia on the expression of Stat3 and p-Stat3 ,and assessed the apoptosis ability of JAR cells in vitro .Methods JAR cells were cultured under hypoxic conditions .Western blot were used to determine the protein expression of Stat3 and p-Stat3 .Cellular apoptosis was monitored by flow cytometry analysis .Results Abnormal morpholo-gy changes in trophoblast cells under low oxygen conditions .After 48 h hypoxic treatment ,the protein of Stat3 and p-Stat3 were significantly decreased(P< 0 .05) ;however ,the level of apoptosis was significantly increased (P < 0 .05) .Conclusion Stat3 and p-Stat3 protein levels were decreased under hypoxia circumstance ,while the cell apoptosis ability was increased in JAR cells .

Objective To investigate the relationship of antithrombin‐Ⅲ activity and thrombosis risk in liver cirrhosis with Child‐Pugh classification .Methods In our hospital from June to December 2014 ,60 liver cirrhosis patients were selected randomly included into this experiment group ,The 60 cases of control group were from medical examination of health in our hospital .The plasma AT‐Ⅲ activity and D‐D concentration in all these cases were detected and analyzed .Results The AT‐Ⅲ in cirrhosis patients were significantly lower than which in healthy persons(P<0 .05) .The lower level of AT‐Ⅲ is in these patients which were in seri‐ous condition(P<0 .05) ,the abnormal rate of D‐D concentration is also higher at the same time(P<0 .05) .Conclusion The detec‐tion of AT‐Ⅲ level in patients with liver cirrhosis is directly related to the severity of clinical and thrombosis risk .The AT‐Ⅲ de‐tection level can be used to judge the patient′s condition and develop appropriate treatment strategies .

Objective To analyze the features of poststroke depression (PSD) between men and women after acute ischemic stroke in China. Methods A total of 1917 ischemic stroke patients were enrolled from the Prospective Cohort Study on Incidence and Outcome of Patients with Poststroke Depression in China. The incidence of PSD and the features were compared between male and female patients. The factors related with PSD of every gender were extracted with Logistic regression analysis. Results The incidence of PSD was higher in women than in men (32.9% vs. 26.6%, P<0.01). There was no difference in the stroke score between women and men (P>0.05). The score of Hamilton Depression Scale was higher in the women than in the men, and the features were similar. Logistic regression analysis indicated that the history of heart disease, history of mental disorders and stroke score related with PSD in women, while the age, history of mental disorders, smoking and stroke score in men. Conclusion The incidence and related factors of PSD 2 weeks after ischemic stroke are different between men and women.

Objective By actual demonstration and study,to construct a theory for a scale to measure clinical communication competence of nursing student,and provide theory basis for developing a simple,reliable,effect clinical communication competence scale that fits the requirements of nursing student.Methods Based on the psychological assessment tools methodology,through the literature analysis and expert consultation method,the election items are revised to 58,then proceed the test of 175 nursing students of PUMC. Results The factor analysis showed that the characteristic value of more than 1 can explain six factors of total variance 53.77%. mainly represents the overall structure of the scale. The 6 factors can be respectively explained as: factor 1 explained the variance of 11.00%,factor 2 was the variance of 10.95%,factor 3 was the variance of 8.59%,factor 4 was the variance of 8.43%,factor 5 was the variance of 8.31%,and factor 6 was the variance of 6.49%. Conclusions Clinical communication ability was a six-dimension system,which includes establishing harmonic relationship,perceptively listening,confirming patient' s problem,jointly participating,conveying effective information and validating the feeling.

Objective To develop a simple, reliable, effect clinical communication competence scale that fits the requirements of nursing student. Methods Based on the means of developing of measure tool, and proceed the test of 175 nursing students of PUMC, the scale become finally having 28 items, including all six dimension in clinical communication competence scale. Results The CVR of this scale is 0. 84,the construction validity analysis show that the six factor explain the item total square differ as 53.77%. The total Cronbach's α coefficient is 0. 83,the Cronbach' sα coefficient of per dimension is from 0.67 to 0. 80,Corrected by the formula of Spearman-Brown, the split-half reliability of the whole scale is 0. 70, the split-half reliability of per factor is 0. 56 ～ 0. 81; The test-retest reliability is 0. 84, The test-retest reliability of per factor is 0. 61 ～ 0. 85. Conclusions The process and results of establishment of "the clinical communication competence scale of the nursing students" meets psychometrics request.

OBJECTIVETo investigate the prognostic factors for non-small cell lung cancer(NSCLC)in patients under 40 years of age.

METHODSThe clinicopathological data of 148 young patients with NSCLC were retrospectively analyzed. Kaplan-Meier and Cox regression analyses were used to analyze the relationship between prognostic factors and survival time.

RESULTSThe patients were followed-up for 6 - 148 months, and the follow-up rate was 100%. In the whole group, 122 patients died and 26 cases were surviving. The 1-, 3- and 5-year survival rates were 54.7%, 10.4% and 5.6%, respectively. The median survival time (MST) was 14.7 months. Kaplan-Meier analysis showed that Karnofsky performance status (KPS), clinical stage, treatment modality and serum CEA were related with prognosis (P < 0.05). Multivariate analysis indicated that KPS, clinical stage, treatment modality and serum CEA were independent prognostic factors (P < 0.05).

CONCLUSIONSKPS, CEA, clinical stage and treatment modalities are independent prognostic factors in young NSCLC patients.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoembryonic Antigen ; blood ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; pathology ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Karnofsky Performance Status ; Lung Neoplasms ; blood ; drug therapy ; pathology ; radiotherapy ; surgery ; Male ; Neoplasm Staging ; Pneumonectomy ; methods ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Young Adult

OBJECTIVETo compare the clinical effects of close manipulative reduction combined with minimally invasive percutaneous plate fixation(MIPPO) and conventional open reduction and internal fixation (ORIF) for the treatment of proximal humerus fractures.

METHODSFrom April 2008 to March 2013, among the 75 patients with fractures of proximal humerus, 26 patients were male and 49 patients were female, ranging in age from 22 to 80 years; 18 patients had injuries caused by traffic accident and 57 patients had injuries caused by falling down. According to Neer classification, there were 49 cases of two-part fractures and 26 cases of three-part fractures. All the patients were divided into two groups: MIPPO group and ORIF group. There were 12 males and 21 females in the MIPPO group,including 22 cases of Neer two parts and 11 cases of Neer three parts, who were treated with close manipulative reduction combined with MIPPO. While the other 42 patients were in the ORIF group,including 16 males and 26 females. Among those patients,27 cases belonged to Neer two parts and 15 cases of Neer three parts, who were treated with ORIF. Length of the incision, blood loss, operating time, early postoperative pain(recorded by VAS), neck-shaft angle of proximal humerus and postoperative function of shoulder(recorded by Constant-Murley score, including pain, function, ROM and muscle length) were compared.

RESULTSThe mean lengths of incision were (6.74 +/- 0.38) cm in MIPPO group and (16.82 +/- 1.74) cm in ORIF group;blood losses were (110.15 +/- 29.49) ml in MIPPO group and (326.19 +/- 59.71) ml in ORIF group; operation times were (48.60 +/- 10.18) min in MIPPO group and (68.84-16.22) min in ORIF group. VAS of patients in MIPPO group on the 1st and 3rd days postoperatively were lower than those of patients in the ORIF group. The postoperative radiographs verified good position of all screws and satisfactory reduction of bone fracture reduction in both groups. All the patients were followed up,and the durig ranged from 8 to 24 months (mean 14.2 months). In the MIPPO group, there was no humeral head necrosis and all patients gained bone union; while in the ORIF group, 3 patients sustained nonunion and received reoperation for bone grafting, and 2 patients sustained humeral head necrosis. The mean Constant-Murley scores of shoulder were 88.94 +/- 2.57 in the MIPPO group and 86.00 +/- 3.36 in the ORIF group.

CONCLUSIONThe close manipulative reduction combined with MIPPO is a better choice for fixation of proximal humerus fractures, compared with conventional plate. This method possesses such advantages as a shorter incision, less disturbance of the blood supply and stable fixation of the fracture, allowing early exercise so that the function of shoulder recovers rapidly.

Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Humeral Fractures ; surgery ; Humerus ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Young Adult

The Wnt signaling exists in every kinds of species and regulates a variety of biological processes including cell fate, proliferation and function, immunity, stress, apoptosis and so on. During the researching, Wnt signaling also plays an important role in chondrocyte differentiation and maturation. So it has been the new spot in pathogenesis of osteoarthritis study.
Animals ; Chondrocytes ; metabolism ; pathology ; Humans ; Osteoarthritis ; metabolism ; pathology ; Signal Transduction ; Wnt Proteins ; metabolism

BACKGROUNDThe extended spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the major pathogens causing pneumonia and have a significant impact on the clinical course. Limited data exist on molecular characterization of ESBL-producing E. coli and K. pneumoniae that cause pneumonia. The aim of this study was to investigate the comprehensive multilevel characteristics of E. coli and K. pneumoniae causing pneumonia in China for the first time.

METHODSE. coli (17) and K. pneumoniae (21) isolates responsible for pneumonia were isolated from 1270 specimens collected in a prospective multi-center study in eight teaching hospitals in China from June to December in 2007. The susceptibilities, ESBL confirmation, sequence typing, blaCTX-M and blaSHV genes, their genetic environment and plasmid Inc/rep types were determined.

RESULTSSixteen E. coli (94.1%) and eleven K. pneumoniae (52.4%) isolates were ESBL producers. About 77.8% and 66.7% of them were resistance to ciprofloxacin and levofloxacin, and 100% were susceptible to imipenem. The most prevalent ESBL gene was CTX-M-14, followed by SHV-2, CTX-M-15, CTX-M-3, CTX-M-65, SHV-12, SHV-26 and SHV-28. SHV-1 and SHV-11 were also detected and coexisted with blaCTX-Ms in five strains, and three strains contained only SHV-1. All CTX-M-14 were detected ISEcp1 upstream and nine were found IS903 downstream and the majority of them (64.3%) were carried by IncF plasmids. All blaSHV were flanked by recF and deoR, located on IncF, IncN, IncX and IncH plasmids. Two SHV-2, one SHV-1 and the only SHV-28 were further preceded by IS26. Genes lacY and lacZ were detected at further upstream of two blaSHV-1. The K. pneumoniae carrying SHV-28 was susceptible to β-lactams, and no mutations or deletions in gene or promoter sequences were identified to account for susceptibility. Multilocus sequence typing experiments showed the ESBL-producing strains were genetically diverse.

CONCLUSIONSThe rate of occurrence of blaESBL in E. coli and K. pneumoniae causing pneumonia was high, and blaCTX-M-14 was dominant and probably mobilized by ISEcp1 mainly on IncF plasmids. Importantly, unexpressed blaESBL genes may occur in susceptible isolates and hence may have clinical implications.

Blotting, Southern ; Escherichia coli ; enzymology ; genetics ; Klebsiella pneumoniae ; enzymology ; genetics ; Plasmids ; genetics ; Pneumonia ; microbiology ; Promoter Regions, Genetic ; genetics ; Prospective Studies ; beta-Lactams ; metabolism