This paper aims to find out the use status of medical and sanitary equipment in primary unit. By means of investigating grass-roots health institutions and summarizing practical works, such problems in equipment were detected as standard vacancy, datedness and laggardness, partly absence, nonstandard management, untimely maintenance and low rate of utilization, etc. This paper puts forward some suggestions corresponding to the above disadvantages.

Objective To analyze the clinical characteristics and to evaluate prognosis of critically ill patients who developed acute renal failure(ARF).Methods A retrospective study was carried out in critically ill patients who developed ARF.APACHE Ⅱ,SAPSⅡ,SOFA and ATN-ISI were used to evaluate outcome of ARF.Results The incidence of ARF in critically ill patients was 19.1% with a high mortality(51.2%).The clinical characteristics of 41 patients with ARF were:mechanical ventilation 65.9%,vasopressor support 46.3%,oliguria 41.5%,number of insufficient organs 2.16,APACHEⅡscore 17.3,SAPSⅡ score 52.0,SOFA score 9.26 and ATN-ISI 0.54.By COX regression,number of insufficient organs(RR 2.54;95%CI 1.316 ~ 4.913)(P=0.006)and requirement of mechanical ventilation(RR 6.0;95%CI 1.102~32.6)(P=0.038)were independent risk factors for ICU mortality of ARF.APACHEⅡscore,SAPSⅡscore,SOFA score and ATN-ISI were demonstrated to predict mortality of ARF patients accurately as indicated by areas under the receiver operating characteristics(ROC)curves of 0.848(95% CI: 0.722~0.974;P

Objiective To observe the morphological changes of rabbits' retina at different time points at which seawater was injected into the vitreous of rabbits. Methods Twenty-five New-Zealand white rabbits were randomly assigned to five groups, as 30 minutes, 2 hours, 6 hours, 12 hours and 24 hours group following the seawater injection in the vitreous. The right eyeball served as experimental eyeball and the left one as control in each group. 0.5ml artificial seawater was injected into the intermedius of rabbits right vitreous. 0.5ml balanced salt sdution was injected into the left vitreous in teh same way. At different time points following the eyeball injury, the morphological changes of retina were observed with light microscope and transmission electron microscope. Results The retina of control eyeballs had clear layers and regular cell shape in retinal structures with conventional staining. For the experimental eyeballs, the ganglion cell layer began to swelling after 30 minutes of seawater injection. The nerve fiber swelled obviously and the mitochondria vesiculated and swelled in the inner segment at 2 hours of seawater injection. The cell population of the inner nuclear layer began to reduce in 6 hours. At 12 hours of seawater injection, the retinal damages included disorganized cell nuclei, decreased cell population in ganglion cells and inner nuclear layer. Mitochondria vesiculated in photoreceptor cells, nuclear membrane shrank and sank inward. The vesiculation on inner and outer segments increased obviously. Conclusions Seawater may cause the morphological changes of rabbits' retina at early stage, and the histological damages become aggravation following the time prolongation. The damages would be unrecoverable 6 to 12 hours after seawater injury.

Objective To explore and design quality assessment system of optimal medical service based on the BYOD and the SERVQUAL theory.Methods All items of medical service were quantified based on the theory of ERVQUAL to build a service bridge between patients and the medical team and at the same time change the traditional manual approach into a network assessment mode supported by information device.Results With the aid of BYOD technology and theory of SERVQUAL, a set of accurate service quality assessments system were built, and medical personnel could communicate with the patients timely and effectively through the system;to make comprehen-sive analysis of the hospital and to improve the quality of medical services continuously.Conclusion BYOD infor-mation technology combined with the theory of SERVQUAL can help enhance the quality of medical service and patients'satisfaction, improve staff quality and update concept and mode of service, optimize the hospital management and ultimately enhance the level of information management of medical service.

OBJECTIVETo introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example.

METHODSA clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice.

RESULTSThe treatment was effective and the patient achieved disease remission.

CONCLUSIONEvidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.

[ABSTRACT]OBJECTIVETo evaluate the accuracy of the watch peripheral arterial tone (Watch-PAT) in the diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS).METHODSA total of 51 outpatients who had chief complaint of sleep snoring were carried out Watch-PAT test and polysomnography (PSG) simultaneously, and the results were statistically compared.RESULTSFifty one patients, consisted of 44 males and 7 females, had the mean age of (45.7±12.0) years (±s) and the mean body mass index of (28.8±3.6) kg/m2.The mean PSG apnea hypopnea index (AHI) was (45.69±12.02) events per hour, and mean Watch-PAT AHI was (35.49±24.49) events per hour. Significant correlation has been detected between Watch-PAT AHI and PSG AHI (r=0.878,P<0.001). The sensitivity and specificity of Watch-PAT were 97.73% and 85.71%, when PSG-AHI≥5/h events per hour was setting as the threshold value to diagnose OSAHS. The diagnostic efficiency of Watch-PAT has been tested by ROC curve, and the area under the curve approached to 0.997.CONCLUSIONThe Watch-PAT was proved as a portable and reliable device of screening patients who were suspected OSAHS.

Objective To prepare the single chain antibody against N protein of SARS-CoV. Methods With N protein of SARS-CoV expressed in E.coli as antigen, we obtained the single chain antibody against N protein by screening the phage display library of human single chain antibodies. Results The anti-N protein antibody didn’t cross-interacte with BSA and the short peptide containing 6 histidines. The specific interaction between the antibody and N protein was inhibited by the anti-N protein monoclone antibody from immunized mice. ConclusionThe single chain antibody we got is specific to N protein of SARS-CoV,it can be a candidate antibody for fast detection of N protein of SARS-CoV and SARS virus particles in clinical trial study of SARS pathogenesis.

Objective Primitive neuroectodermal tumor (PNET) is a rare malignant small round cell tumor .This paper aimed to study the clinical and pathological features of primary pulmonary primitive neuroectodermal tumor . Methods We collected 2 cases of primary pulmonary PNET to review the clinical and pathological features .Immunohistochemical staining was used to detect immune mark-ers, and fluorescence in situ hybridization (FISH) was applied to detect EWS translocation. Results 2 patients were aged 33 years and 17 years.Microscopically, the tumor cell was composed of single small round cells in diffusion or in distribution of sheets or beams , with scant cytoplasm , oval or spindle-shaped nucleus , high mitotic count .Irregular tumor necrosis scattered in the tumor along with visi-ble rosette structure.Immunohistochemical study showed that the tumor cells were positive for CD 99, FLI-1 and Syn, while CKpan, EMA, Desmin, CgA, TTF1, CD34 were negative.EWS/FLI1 translocations were detected positive in both the cases .2 patients died 7 months and 32 months after operation , respectively . Conclusion Primary pulmonary PNET is rare , so the selection of appropriate im-mune markers (CD99, FLI-1, Syn) and FISH for the detection of EWS translocation helps to improve the accuracy of diagnosis .

Objective To investigate the influence of previous abdominopelvic surgery on gynecological laparoscopic operation.Methods A retrospective analysis of 3 283 cases of gynecological diseases by laparoscopic operation patients in Peking University First Hospital from 2007 January to 2012 December,among them,719(21.90％) patients with previous abdominopelvic surgery history (study Group),2 564 (78.10％) patients have no history of abdominopelvic surgery (control group).Study group 719 patients,previous operation times:one time in 525 cases,194 cases were multiple; previous operation:185 cases of gynecological surgery,305 cases of obstetric surgery,108 cases of general surgery,and 121 complex surgery (include at least two kinds of surgery) ;previous operative approach:650 cases laparotomy and 69 cases laparoscopy.Compared two groups of patients with abdominopelvic adhesion and the gynecologic laparoscopic operation situation,analyzed the influence of previous abdominopelvic surgery on abdominopelvic adhesionon and gynecological laparoscopic operation.Results The incidence of abdominopelvic adhesion in the patients with previous abdominopelvic surgery was 51.2％ (368/719),which was significantly higher than that of 8.2％ (211/2 564) in patients without previous abdominopelvic surgery (P＜0.01).But the study group score (median 3) and the degree of abdominopelvic adhesion [mild 49.7％ (183/368),moderate 36.1％ (133/368),severe 14.1％ (52/368)] compared with the control group score (median 2) and degree [mild 55.0％(116/211),moderate 25.6％(54/211),and severe 19.4％(41/211)] were no statistical difference (P=0.930,P=0.684).Super-umbilical primary trocar site were chosen more common in patients with previous abdominopelvic surgery (23.1％,166/719) was significantly higher than that in the control group (3.3％,85/2 564; P＜0.01).And the rate of conversion to laparotomy was 0.6％ (4/719)significantly more than the control groups(0.l％,2/2 564; P=0.023).Compared with other groups,patients with gynecological or complex surgery or multiple operation history presented more severe abdominopelvic adhesion both in the score and degree (P＜0.01).The rate of super-umbilical primary trocar site,hospitalization time,operation time and bleeding during operation in patients with multiple operation history were significantly higher than those with single operation history (P＜0.05) ; the rate of blood transfusion,postoperative complication and conversion to laparotomy showed no statistical difference between the two groups (P＞0.05).Conclusion The laparoscopic operation could be carried out successfully and safely in patients with a history of various abdominopelvic operations,but the conversion rate increases,for patients with a history of multiple operation because of pelvic adhesion increases the difficulty of the laparoscopic operatio

Background and purpose:Breast cancer is one of the most common carcinoma among female patients with high mortalities. Drug-resistance is the major reason that leads to chemotherapy failure in clinical practice. MCF-7/ADR is a multi-drug resistant cell line that was established on the basis of breast cancer cell line MCF-7. This research aimed to investigate the anti-apoptotic effect of c-fos in resistant breast cancer cell MCF-7/ADR, and to compare with its sensitive counterpart MCF-7.Methods:Doxorubicin with various concentrations was used to treat MCF-7 as well as its MDR- counterpart MCF-7/ADR. The growth inhibitory rate of MCF-7 and MCF-7/ADR wasdetermined by MTT assay. Additionally, RT-PCR was used to test the expression of P-gp and c-fos mRNA in MCF-7 and MCF-7/ADR; The expression of c-fos mRNA was detected by RT-PCR after 3 μmol doxorubicin treatment;We further established cell lines that stably interfered with c-fos, named MCF-7/ADR/si-fos-8B, MCF-7/ADR/si-fos-3D. Flow cytometry and MTT assay were used to investigate the apoptosis rate and inhibitory rate in these above cells under the treatment of 5-FU, CDDP or γ-radiation. At last, RT-PCR and Western blot analysis were used to detect the expression of bax, bcl-2, puma, p53.Results:The expression of c-fos and P-gp (MDR-1) was up-regulated in MCF-7/ADR, compared with its sensitive counterpart MCF-7. Additionally, the resistant fold of MCF-7/ADR to doxorubicin was nearly 40; The expression of c-fos was gradually up-regulated after 3 μmol doxorubicin treatment; The sensitivity to drugs (5-FU and CDDP) was increased after c-fos interference while the apoptosis rate was also increased after 5-FU, CDDP and γ-radiation treatment. RT-PCR and Western blot analysis indicated that up-regulation ofbax,puma,p53 after c-fos interference while the expression of bcl-2 was down-regulated.Conclusion:c-fos may act as an anti-apoptotic protein in resistant breast cancer cell line MCF-7/ADR by regulating the expression of apoptosis related proteins, and may play a vital role in the formation of multi-drug resistance phenotype.