OBJECTIVE To evaluate the present condition of bacteriological infection caused by drainage tube after modified radical mastectomy(MRM) and the prevention measure.METHODS Atotal of152 patients with drainage tube after MRM during 2005-2007 were analyzed,bacteria culture of drainage fluid from breast wound or axillary wound were taken in 24 hours after operation.The bacteria or fungi were identified with ATB bacterial analysis apparatus.RESULTS Seventy specimens from 52 patients were positive(positive rate 34.2%).Of 70 strains,40 were Gram-positive cocci,24 were Gram-negative bacilli and the other 6 were fungi.The reasons of infection included subsided immunity defense system,drainage tube application,incorrect aseptic processing or disinfection procedure,and obstruction of drainage tube.CONCLUSIONS The important prevention measures of bacteria infection through drainage tube after MRM include maintenance of aseptic environment in operating room,strict aseptic processing,fluent drainage,and proper indwelling time of drainage tube.

Objective: To evaluate the effect of nutritional support with low carbohydrate formula (Pulmocare, Abbott, America) in patients with pulmenary disease and respiratory failure. Methods: 60 patients were randomly divided into control group and study group. The study group was given Pulmocare and the control group was given Ensure (standard enteral nutrition,Abbott, America). The lipidemia, serum protein, PaCO 2 ,PaO 2 ,VO 2 ,VCO 2 and RQ were measured before and after therapy. Results: The patients' nutritional status of the two groups was improved significantly. The index of artery blood gas analysis was significantly improved( P

Objective To study the association of CD4+CD8+Foxp3+ regulatory T cells with the HIV long term non-progressors(LTNP) in China. Methods Seventy-four HIV-1 infected patients (LTNP group, HIV group and AIDS group)and 16 normal controls were enrolled and the frequency of CD4+CD25+Foxp3+ regulatory T cells were detected by flow cytometry. To study the correlation between CD4+CD25+Foxp3+ regulatory T cells and disease progression, the absolute CD4+ T cells, viral load, apoptosis and activation of T cells were also examined. Results The frequency of CD4+CD25+Foxp3+ regulatory T cells in LTNP group was significantly lower than that in HIV and AIDS group (P<0.05). The frequency of CD4+CD25+Foxp3+ regulatory T cells was inversely related to CD4+ T cells and closely related to viral load and CD38, CD95 expression on CD4, CD8+ T cells (P<0.05). Conclusion The frequency of CD4+CD25+Foxp3+ regulatory T cells of HIV infected LTNP is significantly lower than typical progressors, which indicates that alternation of regulatory T cells may play a protective role in LTNP.

Public hospitals reform is a key roadblock for the ongoing health reform.By means of such experiments as Three openings and three mechanisms,Beijing is practicing a separation of hospital regulation and management and separation of clinic and pharmacy,while building the mechanism of financial subscription for pricing,that of medical insurance adjustment,and that of hospital corporate governance.These measures aim at building a new management structure,operation mechanism and medical service model focusing on quality of care,efficiency and satisfaction.Separation of clinic and pharmacy has lowered drug proportion,average outpatient expense and out of-pocket payment of patients,as well as producing higher patient satisfaction,quality of care and hospital income.Other benefits include better management efficiency indirectly caused by separation of clinic and pharmacy,higher acceptance of the corporate governance,and service model innovation to better serve the people.

Objective:To explore the application of peritoneal dialysis routine examination in reducing the incidence of peritonitis associated with peritoneal dialysis.Methods:From July 2018 to June 2019, 191 patients with peritoneal dialysis who were followed up regularly in the nephrology department were selected as the study subjects.Using convenient sampling method, outpatient follow-up on Tuesday were selected as control group(95 cases) and fixed outpatient follow-up on Thursday were selected as observation group(96 cases). Routine follow-up was performed in the control group, and routine examination of peritonitis was performed in the observation group during the follow-up.Intervention was given immediately when the problems were found to the naked eye and the examination results were abnormal.The incidence of peritonitis in the two groups was compared.Results:Peritonitis occurred in 24 cases in the control group(25.26%), and 9 cases in the observation group(9.38%). The incidence of peritonitis in the observation group was lower than that in the control group, and the difference was statistically significant(χ 2=5.972, P<0.05). Conclusion:The occurrence of peritoneal dialysis-related peritonitis is related to a variety of factors.Paying attention to the routine examination of peritonitis and observing the color of peritonitis, strengthening the aseptic fluid exchange operation, and following up the patients can effectively reduce the occurrence of peritonitis and improve the quality of dialysis.

Chronic kidney disease (CKD) is a serious health problem worldwide, whereas there is still no efficient cure. The gut microbiota plays a crucial role in maintaining human health and disease resistance, and multiple studies have confirmed that the gut microbiota is closely related to the occurrence and development of CKD. Starting from the "gut-kidney axis" theory, this article provides a systematic review of the changes in gut microbiota composition and function in patients with CKD, such as a decrease in the abundance of butyrate-producing bacteria Roseburia and Faecalibacterium prausnitzii. Besides that, the article explores the mechanisms by which the gut microbiota affects CKD progression, such as inflammation and immunity, and also describes the application methods of using the gut microbiota as a therapeutic target for CKD, such as fecal microbiota transplantation, microecologics, and dietary therapy, in order to provide microbial- based targets for the clinical diagnosis and treatment of CKD.

To explore the effect of BBT-I on subjective insomnia and its influencing factors. Methods 60 primary insomnia patients were collected in outpatient department，and divided into two groups：Subjective insomnia group （SI group） and non-subjective insomnia group （NSI group） by sleep data collected by standard polysomnography monitoring and Pittsburgh Sleep Quality Index （PSQI），sleep diaries during the intervention were collected，and the Pre Sleep Arousal Scale（PSAS），Brief Version of Dysfunctional Beliefs and Attitudes About Sleep （DBAS） and the Sleep Hygiene Practice Scale（SHPS） were collected to evaluate the influencing factors related to sleep attitudes，beliefs and behaviors of patients. All patients received BBT-I for 4 weeks，and collected the sleep diaries and PSQI 1 week before and 1 week after treatment. Results Compared with NSI group，SI group had higher arousal index（P<0.05）；compared with NSI group，SI group had lower scores in factor 3 indicated as drug belief and factor 4 representing anticipation of sleep in DBAS，that is，there were more irrational beliefs in SI （P<0.05）.Intragroup comparison showed that there were statistically significant differences insleep latency、sleep efficiency，daytime function and PSQI score in SI group before and after treatment （P<0.05），and there were statistically significant differences in SE difference before and after intervention between SI group and NSI group （P<0.05）.In the subjective insomnia group，daytime functional difference before and after intervention was negatively correlated with the first factor in DBAS（r=0.270，P=0.037）. daytime functional difference before and after intervention was negatively correlated with PSAS（r=0.268，P=0.039）；The difference of sleep latency before and after intervention was negatively correlated with physiological stimulation of PSAS（r =0.288，P=0.042）. Conclusion Compared with nonsubjective patients，subjective insomnia patients have higher arousals and more irrational beliefs and attitudes.BBT-I may improve sleep latency/、sleep efficiency，daytime function and sleep sensation in subjective insomnia patients.

The purpose of our study is to evaluate the diagnostic performance of radiomics in multi-class discrimination of lymphadenopathy based on elastography and B-mode dual-modal ultrasound images. We retrospectively analyzed a total of 251 lymph nodes (89 benign lymph nodes, 70 lymphoma and 92 metastatic lymph nodes) from 248 patients, which were examined by both elastography and B-mode sonography. Firstly, radiomic features were extracted from multimodal ultrasound images, including shape features, intensity statistics features and gray-level co-occurrence matrix texture features. Secondly, three feature selection methods based on information theory were used on the radiomic features to select different subsets of radiomic features, consisting of conditional infomax feature extraction, conditional mutual information maximization, and double input symmetric relevance. Thirdly, the support vector machine classifier was performed for diagnosis of lymphadenopathy on each radiomic subsets. Finally, we fused the results from different modalities and different radiomic feature subsets with Adaboost to improve the performance of lymph node classification. The results showed that the accuracy and overall 1 score with five-fold cross-validation were 76.09%±1.41% and 75.88%±4.32%, respectively. Moreover, when considering on benign lymph nodes, lymphoma or metastatic lymph nodes respectively, the area under the receiver operating characteristic curve of multi-class classification were 0.77, 0.93 and 0.84, respectively. This study indicates that radiomic features derived from multimodal ultrasound images are benefit for diagnosis of lymphadenopathy. It is expected to be useful in clinical differentiation of lymph node diseases.
Elasticity Imaging Techniques ; Humans ; Lymph Nodes ; Lymphadenopathy ; Retrospective Studies ; Ultrasonography