Objective To investigate if edema caused by rosiglitazone is associated with the change of aldosterone level. Methods Plasma aldosterone levels in different periods from patients treated with rosiglitazone combined with insulin were measured.Type 2 diabetes patients who have been treated with insulin alone were divided into two groups: patients treated with rosiglitazone(4mg/d) combined with insulin(RSG+insulin group), or treated with insulin alone (insulin group)(n=10). Aldosterone levels, incidence of edema and weight gain were monitored every two months during six months. Results The incidence of edema and weight gain were higher in RSG+insulin group than in insulin group. After two months, aldosterone levels were higher in RSG+insulin group than in insulin group[(77.8±25.9)vs(60.2±27.6)pg/ml,P＞0.05],but it had no statistical difference; after four months, aldosterone levels were higher in RSG+insulin group than in insulin group[(87.2±27.1)vs (61.5±25.6) pg/ml,P＜0.05]. After six months, aldosterone level recovered gradually,it had no statistical difference compared with that of control[(77.0±21.0)vs(69.6±21.7) pg/ml,P＞0.05]. Conclusions The cause of early edema in type 2 diabetic patients treated with rosiglitazone combined with insulin was probably assosiated with elevated aldosterone level.

Objective To understand the epidemiological characteristics of a healthcare-associated infection(HAI)outbreak due to Norwegian scabies in a hospital,and provide basis for clinical prevention and control of HAI.Methods Through epidemiological investigation,all suspected patients and close contacts were investigated and traced,three dimensional distribution of patients was described,a series of effective comprehensive prevention and control measures were formulated and implemented.Results A total of 16 cases of Norwegian scabies infection occurred in November 3-16,2015,the most frequent cases were in November 11(n=5),the onset time of infection was concentrated in November 9-11(n=10),accounting for 62.50%of total cases.Spatial distribution of 16 cases: 12 cases were in general internal medicine department,2 in nursing department,and 2 were relatives of employees.Population distribution: patients aged 50-59(n=7),female(n=13),and nursing staff(n=9).After taking comprehensive prevention and control measures and medication treatment,16 infected persons were all cured,the cure rate was 100%,there was no new cases occurred in the hospital,epidemic was under control.Conclusion Norwegian scabies is highly contagious,it can cause epidemic in local area.In order to avoid spread of scabies infection in hospital,health care workers should strengthen the diagnosis and precaution level of the disease.

Penicillin is a kind of β-lactam drug which has been applied in the clinical treatment firstly in the world, and it has still been widely used at present. The synthesis and regulation mechanism of Penicillium chrysogenum, which is used to produce penicillin, has been studied quite maturely, but its proteomics research started relatively late and fewer reports were published. This paper reviews the synthesis and application of penicillin, transformation of Penicillium chrysogenum, and the research progress of its proteomics. On this basis, the study highlights the advantages of proteomics in the research of protein expression.
Penicillins ; biosynthesis ; Penicillium chrysogenum ; metabolism ; Proteome ; Proteomics

OBJECTIVETo compare the effectiveness of percutaneous microwave ablation ( MWA) versus hepatectomy for multifocal hepatocellular carcinoma.

METHODSFrom August 2002 to March 2012, one hundred and twenty-two patients with multifocal hepatocellular carcinoma (diameters 1 to 7 cm, 2 to 4 lesions) were treated by either complete MWA or radical hepatectomy, and their clinical data were collected and analyzed.The patients were divided into MWA group (n = 50) and resection group (n = 72), and the resection group was matched by MWA group based on clinical parameters. The survival and complications in the two groups were compared.

RESULTSThe overall 1-, 3- and 5-year survival rates were 100.0%, 73.0% and 62.0%, respectively, in the MWA group, and 80.0%, 56.0%, and 41.0%, respectively, in the resection group (P < 0.05). The corresponding recurrence-free survival rates were 88.0%, 63.0%, and 52.0% in the MWA group, and 68.0%, 45.0%, and 36.0%, respectively, in the resection group (P< 0.05). The multivariate Cox regression analysis indicated that albumin level, performance status, treatment modality, and tumor size were independent prognostic factors.

CONCLUSIONCompared with hepatectomy, percutaneous microwave ablation is a minimally invasive and reproducible procedure, and can improve the survival in patients with multifocal hepatocellular carcinoma.

Carcinoma, Hepatocellular ; mortality ; radiotherapy ; surgery ; Catheter Ablation ; Genetic Engineering ; Hepatectomy ; mortality ; Humans ; Liver Neoplasms ; mortality ; radiotherapy ; surgery ; Microwaves ; therapeutic use ; Regression Analysis ; Survival Rate ; Treatment Outcome

AIM: To construct the recombinant adenovirus carrying fusion suicide gene CDglyTK with the C promoter(Cp),one of the key factors in controlling Epstein-Barr virus latent gene expression,and to investigate if the Cp mediates the expression of CDglyTK in CNE1 cells and kills the cancer cells specifically.METHODS: The tk,cd,Cp sequences were amplified by PCR and subcloned into corresponding sites of pDC316 vector with directional cloning method to construct the pDC316-CP-CDglyTK.The plasmid was analyzed by DNA sequencing and enzyme digestive method.The recombinant adenovirus of Ad-Cp-CDglyTK was packaged,amplified and purified in 293 cells,and the virus titre was determined by TCID50 method.The CDglyTK gene expression in CNE1 and NP69 were examined by reverse transcription-polymerase chain reaction(RT-PCR) after in vitro transfection in CNE1 and NP69 cells.The killing effect of Ad-Cp-CDglyTK/GCV+5-FC on CNE1 cells was detected by MTT method.RESULTS: The results of restriction enzyme digestion and DNA sequencing showed that the tk,cd,and Cp gene were inserted into the pDC316 plasmid in correct orientations.The titer of the recombinant adenovirus was 5.6?1012 TCID 50/L.The Cp fragment was amplified from the total RNA of the transfected CNE1 cells by RT-PCR.The mRNA of CDglyTK gene expression was not detected in NP69 cells.The MTT results showed that after administration of GCV and 5-FC,the killing effects of fusion gene were much better than those of single gene therapy.CONCLUSION: The C promoter specifically mediates the expression of CDglyTK in CNE1 cells.The Ad-Cp-CDglyTK/GCV+5-FC has much better killing effects on CNE1 cells than single gene.

0.05).The effective rate on relieving traditional Chinese medical syndrome was 95.0% in the treatment group and 73.3% in the control group,the difference being significant(P0.05).After treatment,the parameters of 24-h dynamic blood pressure were improved in both groups(P

Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.

Objective To investigate the significance of monitoring P(c-a)CO2 (the gradients between transcutaneous PCO2 and arterial PCO2) in patients with septic shock.Method 31 patients with early septic shock were enrolled as the study group and 20 patients with stable hemodynamics as the control group from Fab.2013 to Sept.2014 in our Intensive Care Unit (ICU).The patients with septic shock were treated guided by early goal directed therapy (EGDT) within 6 hours since hospitalization.The differences of baseline P(c-a) CO2 levels and other index as arterial lactate (LAC) concentration between two groups and the variations of these indexes after EGDT in the study group were compared respectively.Results The baseline levels of P(c-a)CO2 and LAC in patients with septic shock were significantly higher than in patients of control group: (21.2 ± 10.1) mmHg vs.(7.5 ±4.6), P =0.000, and (4.0±2.4) mmol/ Lvs.(1.6 ± 0.5), P =0.000.The areas under receiver operator characteristic (ROC) curve (AUC) for baselineP(c-a)CO2 and LAC were 0.918 (95％ CI: 0.843-0.992) and 0.840 (95％ CI: 0.719-0.962) respectively.A threshold of 14.0 mmHg for P(c-a)CO2 and 2.1 mmol/L for LAC discriminated patients with septic shock from without shock with the same sensibility of 83.9％ and the same specificity of 90.0％, respectively.With regard to prognosis (Day 28), AUC for baseline P(c-a)CO2 and LAC were 0.739 (95％ CI: 0.562-0.917) and0.702 (95％ CI: 0.514-0.889) respectively.A threshold of 21.5 mmHg for P(c-a) CO2 and 3.9 mmol/L for LAC discriminated survivors from nonsurvivors with the same sensibility of 71.4％ and the same specificity of 70.6％ respectively.31 patients in the study group completed EGDT within 6 hours after the admission, 16 (51.6％) passed EGDT and 13 (81.3％) survived, 15 (48.4％) failed EGDT and 4 (26.7％) survived, and survival rates were significantly different, F =9.314, P =0.004.After EGDT, P(c-a) CO2 (18.8 ± 9.4) mmHg and LAC (3.3 ± 2.4) mmol/Lreduced significantly compared with the baselines, all P =0.000.AUC then for P(c-a) CO2 and LAC were 0.742 (95％ CI: 0.562-0.921) and 0.769 (95％ CI: 0.593-0.945), respectively.A threshold of 18.3 mmHg for P(c-a)CO2 and 3.1 mmol/L for LAC discriminated survivors from nonsurvivors with the same sensibility of 71.4％ and the specificity of 71.4％ and of 76.5％ respectively.P(c-a) CO2 and LAC of patients passed EGDT reduced significantly compared with those failed EGDT: (14.8 ± 7.5) mmHgvs.(23.6±9.6) mmHg (P=0.012)、 (2.5±1.5) mmol/L vs.(4.3±2.9) mmol/L (P=0.038), and so did with their baseline : (14.8±7.5) mmHgvs.(18.0±8.1) mmHg, (P=0.042)、 (2.5±1.5) mmol/Lvs.(3.2±1.8) mmol/L, P=0.043.In patients failed EGDT, P(c-a)CO2 and LAC changed little after EGDT, from (24.6 ± 9.2) to (23.6 ± 9.6) mmHg (P =0.238) and from (4.8 ± 2.5) mmol/L to (4.3 ± 2.9) mmol/L (P =0.629).When baseline levels were compared between patients passed EGDT with those failed EGDT, P(c-a) CO2 was (18.0 ±8.1) mmHg vs.(24.6 ± 9.2) mmHg (P =0.042), LAC was (3.2 ± 1.8) mmol/L vs.(4.8 ± 2.5) mmol/L (P =0.050).Conclusions P(c-a) CO2 ＞ 14.0 mmHg could play a role in recognizing early septic shock.EGDT was an effective therapy for the disease and P(c-a)CO2 level could reflect the efficacy of EGDT.P(c-a)CO2 ＞ 21.5mmHg before EGDT and P(c-a) CO2 ＞ 19.3 mmHg after EGDT both could predict the prognosis of patients with septic shock.All above correlated well with LAC and represented a new efficient technique to assess tissue microperfusion.

Objective To explore the relations of the doctor-patient relationship to psychological security and stress.Methods Totally 430 operation patients were selected and followed-up.A survey was performed using the Security Questionnaire (SQ),the Patient Doctor Relationship Questionnaire 13-Item Version (PDRQ-13),the Hospital Stress Rating Scale (HSRS) Results The average score of SQ was lower than medium value in operation patients.The SQ scores of operation patients with emergency operation were 39.50±10.51,lower than those of selective operation which were 49.02±10.37 and limited operation which were 47.67±10.29 (P ＜ 0.05).The SQ scores of operation patients who didn't provided themselves were 37.33±10.10,lower than those of basically which were 40.10±10.83 and partly provided for themselves which were 43.50±10.51 (P＜ 0.05).The SQ scores of operation patients in severe group according severity of illness were 37.13±10.40,lower than those of them in mild group which were 39.19±10.24 and moderate group which were 41.38±10.01 (P＜ 0.01).The SQ scores of post-operation patients were 44.32±9.96,higher than post-operation patients which were 40.36±10.81 (P ＜ 0.01).The lack of comforts (LC),lack of information (LI) and risks of serious disease (RSD) scores of post-operation patients were 49.23±30.62,30.46±21.42,52.84±31.22,lower than those of post-operation patients which were 52.37±32.06,35.25±20.14,80.12±33.18 (P ＜ 0.05).The path analysis showed that the regression relationship between SQ scores and PDRQ scores,RSD scores was established (β=0.40,-0.26,P ＜ 0.01),and the PDRQ-13 scores was a mediator between the scores of LC,LI,RSD and the SQ scores (β=0.40,P＜0.01).The PDRQ-13 scores was a adjustor between the RSD scores and the SQ scores (β=-0.34,P ＜ 0.01).Conclusions The operation patients have a low level of the sense of security which is statistically significant with surgical types,the ability to care for themselves and severity of illness.The sense of security of post-operation patients were higher than those of pre-operation patients.The recognition of physician-patient relationship may be play a mediating and adjusting role between the sense of security and stress.The surgical stress affect patient security and physician-patient relationship.

OBJECTIVE:To optimize the placement of extra-machine medicines in the automated pharmacy and establish a ra-pid dispensing area to shorten medicine dispensing time. METHODS:12 588 prescriptions made within one week were collected from the outpatient pharmacy of our hospital,in which 29 kinds of extra-machine medicines used frequently were clustered on the basis of Pearson correlation coefficients. The extra-machine medicines used at a higher frequency were arranged in the storage posi-tions near to the medicine dispensing window,and those related to the above-mentioned medicines were stored in the positions adja-cent to them,thereby a rapid dispensing area was established. The effect of the above-said method was evaluated by comparing the time it took for the pharmacist to dispense medicines one week before and after the establishment of the rapid dispensing area. RE-SULTS:29 kinds of extra-machine medicines were clustered into 4 major categories,and stored in 4 positions in the rapid med-icine dispensing area respectively,and then the position codes were assigned. After the rapid dispensing area was established,the average single prescription dispensing time for the pharmacist decreased by about 9 s (40.43 s vs. 31.43 s,P<0.01). CONCLU-SIONS:The establishment of the rapid dispensing area based on cluster analysis method has increased the efficiency of dispensing medicines in the outpatient pharmacy of our hospital.