BACKGROUND: BK viral infection after renal transplantation influences the prognosis of BK virus-associated nephropathy in renal transplant recipients. The disease has been widely studied in foreign countries.OBJECTIVE: This study was designed to sum up the diagnosis and treatment of BK virus-associated nephropathy after renal transplantation.RETRIVAL STRATEGY: Using the terms "renal transplantation; BK virus" in the English language, manuscripts responsible for BK virus-associated nephropathy after renal transplantation that were published from January 2000 to January 2007 were retrieved from the PubMed database. A total of 206 manuscripts were obtained and primarily screened. Inclusion criteria: studies addressing BK virus-associated nephropathy after renal transplantation. Exclusion criteria: repetitive studies.LITERATURE EVALUATION: The included manuscripts were primarily from PubMed database. Manuscripts were primarily original and review studies.DATA SYNTHESIS: BK virus can be found in the urine of 3%-40% of adult renal transplant recipients. BK virus reactivation rate is very high, but the histological manifestations of BK virus associated nephropathy are found only in a small number of renal transplant recipients. The prognosis of BK virus associated nephropathy is very poor. BK virus associated nephropathy develops into renal failure, leading to transplant loss, in 30%-50% patients. BK virus-caused renal transplant disease must be diagnosed according to histological manifestations. Viral infection should be primarily confirmed, but serological measurements have no predominant effects. Electron microscopy should be involved in the assessment of renal graft biopsy, especially when renal failure factors are unknown, as through the use of electron microscope, viral particles in the nucleus, cytoplasm and outside of the cells could be detectable. Viral antigen in the urine sample of patients with BK viruria can be detected by nucleic acid hybridization method, immunofluorescence, and ELISA. Cidofovir is an effective medicine for treatment of BK virus-associated nephropathy, but its potential nephrotoxicity, proper dose, pharmacokinetics, safety, tolerance, anti-BK viral activities have not been confirmed. So fresher study should be required for aforementioned uncertainties.CONCLUSION: BK virus-associated nephropathy has poor prognosis and should be diagnosed according to histological examinations. BK virus-associated nephropathy has been treated primarily by symptomatic supportive treatment and reducing the dose of immunosuppressive agents.

BACKGROUND:Ankle fractures combined with deltoid ligament injury are not uncommon in clinical practice, prone to misdiagnosis and missed diagnosis, resulting in ankle instability, chronic pain and traumatic arthritis. In recent years, because of the research and development of anatomy and biomechanical characteristics of deltoid ligament, the treatment and surgical methods of ankle fracture combined with deltoid ligament injury have progress and development, but it remains controversial. OBJECTIVE:To evaluate the clinical effect of suture anchor repair in the treatment of ankle fracture combined with deltoid ligament injury. METHODS: Twenty-seven patients with ankle fracture combined with deltoid ligament injury were selected between January 2010 and January 2013. The lateral maleolus and posterior maleolus fracture patients were treated with open reduction and internal fixation, and al the deltoid ligament injury patients were treated with anchor repair. The tibiofibular syndesmosis isolated patients received internal fixation with a cancelous bone screw. RESULTS AND CONCLUSION:Al 27 patients were folowed-up for 11-35 months, averagely 23 months. The evaluation according to the American Orthopaedic Foot and Ankle Society score system showed that the excelent and good rate was 74.1%. The results indicate that anchor could perfectly restore the stability of ankle joint.

Objective To investigate nurses′ learning motivation and learning satisfaction with continued education and analyze its influencing factors. Method One hundred and seventy-nine nurses were enrolled in the survey and the general information questionnaire, education participation scale and continuing education learning satisfaction scale were used in the investigation. Results The average score by nursing education participation scale was (3.26 ± 0.59), and that of continuing education learning satisfaction scale was (2.74 ± 0.48). There were statistically significant differences in age, length of employment, professional title, marital status, employment mode between the scores by the two scales (P < 0.01). Conclusions Nurses′ learning motivation and learning satisfaction with continuing education are in the medium level. Pertinent guidance such as bringing continuing education in depth and width is suggested to improve satisfaction and motivations of nurses.

Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reliance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthily,which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns.This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the communication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

Multidrug resistance(MDR) is the leading cause of treatment failure in cancer therapy. Overexpression of the ATP-binding cassette (ABC) transporter family increases the cellular efflux, decreases the effectiveness of chemotherapeutic agents,and results in MDR. In particular,overexpression of P-glycoprotein and its encoding genes(mdr1) is the major mechanism. It is feasible for overcoming MDR by studying the factors affecting mdr1 gene expression so as to block the expression of mdr1. Pregnane X receptor(PXR) can regulate the expression of MDR proteins, suggesting that it be possible to overcome drug resistance by regulating PXR. In this paper,the relation between PXR and MDR and recent development of PXR antagonists to pharmacologically modulate PXR are reviewed. The review proposes that selectively preventing the elevation of MDR levels by regulating PXR rather than non-selectively inhibiting the MDR activity by using MDR inhibitors can be a less toxic approach to overcome drug resistance during cancer therapy.

Objective To evaluate the application status of China Disease Prevention and Control Information System of Hy?datid Disease,in which questions existed are summarized in order to promote the system update. Methods A questionnaire was designed and distributed to Inner Mongolia,Sichuan,Tibet,Gansu,Qinghai,Ningxia,Xinjiang and Xinjiang Production and Construction Corps to evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease assistant with telephone. Results The recovery rate of questionnaires was 87.5%. The statistics of closed questions showed that national application rate of the China Disease Prevention and Control Information System of Hydatid Disease was 100%,of which 15.3%were low frequency users,57.1%believed the system was necessary,28.6%considered it was dispens?able,and 14.3%believed that it was totally unnecessary. The statistics of open?ended questions indicated that 6 endemic regions suggested to increase the guidance and training,while 4 endemic regions had opinions on sharing the information of the national infectious disease reporting systems and hydatid disease prevention and control information system,and the opinions on turning monthly report to quarterly report,and increasing statistics and analysis module,and 3 endemic regions deemed that the system had logic errors and defects. Conclusion The problems of the system are mainly focused on the existence of systemic deficien?cies and logic errors,lacking of statistical parameters and corresponding analysis function module,and lacking of the guidance and training,which limits the use of the system. Therefore,these problems should be resolved.

Objective To assess the effect of intraperitoneal interstitial implant of Sustained-release 5-Fluorouracil during operation for advanced rectal cancer. Methods One hundred and four cases with advanced rectal cancer were enrolled into the study and divided into 3 groups: treatment group 1(n = 37), underwent combined hypotonic peritoneal chemo-hyperthermia and Sustain-released 5-fluorouracil implantation treatment during operation; treatment group 2(n = 34), underwent combined intraoperative hypotonic peritoneal chemohyperthermia and early postoperatively intraperitoneal chemotherapy treatment; and control group(n = 33),underwent peritoneal lavage during radical resection alone. Results Digestive tract toxicity in group 1 was significantly lower than that in group 2(2. 70% vs. 20. 59%, x2 = 9. 104, P ＜ 0. 05). There were significant difference on 1 year survival rate among the three groups. The 2-year survival rate of group 1 was significantly higher than that in the control group (78. 37% vs. 48. 48%, x2 = 1. 297 ,P ＜ 0. 05). After two years follow-up the 2-year local recurrence rate of group 1 was significantly lower than that in the control group(21.62% vs 32. 35 %, x2 = 7. 001, P ＜ 0. 05). However, no significant difference was found compared to group 2, which was 32. 35%. Conclusion lntraperitoneal interstitial implant of Sustain-released 5-Fluorouracil during operation is an effective intraperitoneal chemotherapy with mild side effects for advanced rectal cancer.

Objective To compare three ultrasonic methods of transabdominal , transvaginal , and transperineal ultrasonogra-phy for the cervical length ( CL) in predicting the preterm birth .Methods The pregnancy women with threatened preterm labor in Hunan Provincial Hospital of Maternal and Child Health from January , 2012 to December, 2013 were chosen to measure the cervical length by sonography , and were randomly divided into three guoups ( 280 pregnancy women in each group ) , including Group Ⅰ( transabdominal ) , groupⅡ( transvaginal ) , and group Ⅲ ( transperineal ) .The cervical length and the pregnancy outcome were fol-lowed up.Results The acceptance rate of group Ⅱ(81.8%=229/280) was significantly lower than that of groupⅠ(100%=280/280)and group Ⅲ(99.3%=278/280)( P <0.05).The realization ratio of the cervix in group Ⅰ(85.0%=238/280) was signifi-cantly lower than that of group Ⅱ(98.7%=226/229) and group Ⅲ (98.2%=273/278) ( P <0.05).The preterm birth rate of 48.6%(18/37) in groupⅠ, 37.8%(28/74) in groupⅡ, and 37.1%(33/89) in groupⅢin the pregnancy women with CL <3 cm was significantly higher than the corresponding preterm birth rate of 17.9%(36/201) in groupⅠ, 13.2%(20/152)in groupⅡ, and 13.6% (25/184) in groupⅢin the pregnancy women with CL≥3 cm.The sensitivity of groupⅠ(33.3%=18/54) was significantly lower than that of group Ⅱ(58.3%=28/48) and group Ⅲ(56.9%=33/58).Conclusions The cervical length measured by ultra-sound is valuable in predicting preterm birth among the pregnancy women with threatened preterm birth .The transperineal ultrasonogra-phy is superior to transabdominal and transvaginal ultrasonography in predicting preterm birth , and is worth being popularized .

Peking University Shenzhen Hospital launched a reform to outsource its logistic support service to overcome the setbacks of overstaffing,poor service and high costs with the existing logistic departments since its opening.Practice of a decade has raised the quality of its logistic support system and lowered service costs.Furthermore,the reform has optimized the hospital's human resource structure,and improved performance of the hospital staff,paving the way for better social benefits of the hospital.

Anemia, Aplastic ; mortality ; pathology ; therapy ; Child ; Disease-Free Survival ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Risk Factors ; Severity of Illness Index ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors