A Kinase Anchor Proteins ; Cardiomegaly ; metabolism ; Humans

Objective To discuss the nursing management for patients receiving percutaneous fluoroscopy - guided gastrostomy (PFG) for the treatment of dysphagia caused by head and neck cancer. Methods A total of 15 patients with dysphagia caused by head and neck cancer received PFG. Before PFG sufficient preparation and psychological nursing care were carried out for all the 15 patients. After the operation the patients were kept under close observation for any changes in his or her clinical conditions. Proper prevention measures against complications were adopted. Results PFG procedure was successfully accomplished in all 15 patients. Postoperative complications included gastric bleeding (n = 1), stoma infection (n = 1) and proctoptosis (n = 2), and the disorders were recovered after clinical management. After PFG intravenous nutrition was no longer employed in all patients, and enteral nutrition was conducted. The quality of life was significantly improved in all patients. Conclusion PFG is technically - simple and minimally- invasive with fewer complications. This technique provides a new way to give enteral nutrition for patients with dysphagia caused by head and neck cancer. Excellent psychological nursing, sufficient preoperative preparation, comprehensive postoperative nursing care and medical advices at the time of discharge are the key points to ensure a successful PFG.

Objective To analyze the distribution and influential factors of exam results in medical students' general surgery theory course.Methods 171 medical students were selected as subjects by cluster sampling,and the distribution and influential factors of exam results were analyzed.SPSS 17.0 software was used for statistical analysis,measurement data with (-x) ± s,and normality test with Kolmogorov-Smirnov test.Those quantitative data which do not meet the normal distribution were compared with Mann-Whitney U and Kruskal-Wallis H test.Rank transformation univariate multi-factor variance of LSD (Levene test equal error variance between groups) or Tamhane method (Levene test range error variance between groups) were compared between two groups(3-4) and the influence factors of whether the grade was good was analyzed by single factor and multi factor non conditional Logistic regression model,with the test level of alpha=0.05.Results The distribution of total exam results was normal.77 score was outlier,and the scores of female students were higher than those of male students.Scores of total exam results,multiple-choice questions and essay questions in different classes were significantly different.Data from multivariate logistic regression analysis showed that male students(OR=0.212,95％CI:0.077-0.584) were unfavorable factor for good exam results,while higher scores in noun explanation (OR=12.160,95％CI:1.985-74.495),multiple-choice questions (OR=9.887,95％CI:2.997-32.617),essay questions(OR=18.323,95％CI:6.593-50.928) were favorable factors.Conclusion The cause analysis of score's outlier and sex difference should be strengthened,and the influence of examination items on score should be emphasized.

Objective To investigate the clinicopathological features of undifferentiated embryo-nal sarcoma of the liver (UESL). Methods The clinical data of 9 UESL cases treated in our hospital between 1996 and 2007 were retrospectively analyzed. Results The patients were children and young adults. Clinical presentation was typically an abdominal mass that may be accompanied by pain and fe-ver. Tumors were all removed surgically in the 9 patients. Conclusion UESL is an unusual malignan-cy of the liver. Discrepancy of internal architecture between US and CT is one of the important charac-teristic of UESL. Whenever feasible, surgical resection should be attempted as a part of combination modalities. Modern rnultimodal treatment and supportive therapy might promote the survival rate.

Next generation sequencing (NGS) has been applied in scientific research and clinical practice of mature lymphoid malignancies. The applications of NGS in the study of pathogenesis, treatment and prognosis evaluation, mechanisms of resistance to treatment in lymphoid malignancies have been reported in the 57th American Society of Hematology (ASH) annual meeting. This article summarized the advances in the use of NGS in mature lymphoid malignancies by reviewing several representative reports.

Objective To compare clinical Pseudomonas aeruginosa different sources of β-lactamase-resistant phenotype differences,as to provide theoretical basis for guiding clinical rational use of antibiotics.Methods Isolation of 478 strains of Pseudomonas aeruginosa were collected from clinical specimens in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2015,by VITEK 2 Compact bacteria identification and drug sensitivity analysis of advanced expert system for β-lactamase-resistant phenotype,statistical analysis of drug resistance phenotype and antibiotic resistance.Results 478 strains of Pseudomonas aeruginosa were mainly composed of phenotype 5 and phenotype 3.Sputum,drainage fluid and bile duct bile specimens of Pseudomonas aeruginosa were based on phenotype 5,accounted for 31.08％,34.71％ and 38.46％.Multiple comparison x2 were 3.893,4.071 and 5.595,There was no statistical difference between groups compare significance (P＞0.05).Urine,secretions and whole blood samples of Pseudomonas aeruginosa were phenotype 3,accounted for 34.88 ％,27.78 ％,45.45 ％;Multiple comparison x2 were 6.654,9.956 and 9.852.There was no statistical difference between groups compare significance (P＞0.05).Sputum,drainage of liquid,bile duct bile and urine,secretion,whole blood specimens respectively source of Pseudomonas aeruginosa resistant phenotype distribution of two comparative difference was statistically significant (x2 =15.056～22.050,P＜0.05).Comparing the resistance of different β-lactamase-resistant phenotypes in Pseudomonas aeruginosa isolates from different sources:the sputum specimen source in imipenem,meropenem,piperacillin and piperacillin/tazobactam had significant difference (x2 =22.225～39.025,P＜0.05).There was statistical significance in department of hepatobiliary surgery only ceftazidime and meropenem differences (x2 =21.890～22.872,P＜0.05).Conclusion The phenotypic analysis of β-lactamase-resistant phenotypes of Pseudomonas aeruginosa from different specimens was different,which provided a theoretical basis for guiding the clinical application of antibiotics and the control of nosocomial infection of Pseudomonas aeruginosa.

Objective To study the expression of P27,c-fos protein in neuron cell after ischemia and reperfusion accompany with the DWI imagings in rat brain.Methods 12 healthy SD rats with MACO were divided into three groups.Group A,ischemia 30 minutes with 60 minutes reperfusion;Group B,ischemia 60 minutes with 60 minutes reperfusion.Group C,ischemia 60 minutes.The DWI imaging was scanned after surgery immediately.The expressions of P27 and c-fos were determined by immunochemistry procedure.Results The P27 protein positive reaction was not detected in all ischemia and reperfusion groups.The c-fos protein positive reaction was observed in the cortex and basal ganglion in all groups.The hyperintense signal was presented the in DWI after fifteen minutes following the ischemia.Conclusions P27 protein is endogenous cyclin dependent kinase inhibitor.There may be the relationship between low expression of P27 protein in rat brain and the programmed cell death in neuron after the ischemia.C-fos protein participates in the neuron cell injury after the ischemia.DWI has good sensitivity to acute cerebral ischemia.

OBJECTIVETo investigate the clinical results of external fixation and AO titanium elastic intramedullary nailing for treatment of tibia-fibula comminuted closed fractures.

METHODSFrom June 2010 to June 2012,58 patients with tibia-fibula comminuted closed fractures were treated with external fixation and AO titanium elastic intramedullary nailing, including 31 males and 27 females with an average age of 38.5 years old ranging from 21 to 57 years old. According to the system of AO Classification, the fractures were classified as type B1 in 9 cases,type B2 in 7 cases, type B3 in 10 cases, type Cl in 14 cases, type C2 in 12 cases,and type C3 in 6 cases. According to the system of Winquist-Hanson,the fractures' comminuted were classified as grade 1 in 23 cases, grade 2 in 17 cases, grade 3 in 12 cases, and grade 4 in 6 cases. According to the system of Johner-Wruhs, clinical results were compared between different type and grade groups by the time of last followed-up.

RESULTSAll 58 patients were followed up with an average time of 6.8 months (ranged from 18 to 36 weeks). All fractures had clinical healing with an average time of 28 weeks (ranged from 24 to 32 weeks). The total rate of good to excellent results was 91.4%. The rate of good to excellent in the group of grade 1 was higher than that of other grades. The complication rates and fracture healing time would increase respectively with higher Winquist-Hanson's grade. The complication rates in the group of type C3 was higher than that of other types, but the rate of good to excellent was lower than that of other types. The complication rates in the group of type B1 was lower than that of other types,but the rate of good to excellent was higher than that of other types.

CONCLUSIONMinimal invasiveusing AO titanium elastic intramedullary nailing combined with external fixation for treatment of tibia-fibula fractures especially for the multiple-segment,long spiral mild-to-moderate comminuted with hidden fracture can get satisfactory reduction and reliable fixation,it conformes to the principle of BO completely, protects the fracture end blood supply,reduces the external fixation time, has less skin soft tissue complications, postoperative function recovered satisfactorily.

Adult ; Bone Nails ; Bone Plates ; External Fixators ; Female ; Fibula ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Closed ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tibia ; injuries ; surgery ; Young Adult

Objective To establish a simple, stable, specific and sensitive method for detection of Tyzzer ’ s or-ganism by reverse dot blotting ( RDB) .Methods Primers and specific probes were designed according to the conservative sequence of Tyzzer 16S rDNA.The forward primer was labeled with biotin .The reverse dot blotting method was established followed by PCR amplification .The specificity and sensitivity of this method were determined .Next, 41 mice and 38 rats were examined by RDB , ELISA and IFA .Results The RDB method showed a high specificity , and in the testing of the 79 laboratory animals , its limit of detection was 4.5 ng/μL.Compared the results of ELISA and IFA , its consistence with ELISA was 100%and the positive rate was 7.59%(6/79), the consistence with IFA was 92.4%(73/79), and the posi-tive rate was 0%.Conclusions An accurate, sensitive and specific method in combination with PCR and RDB in detection of Tyzzer’ s organism is established in this study .

Talents are core competitiveness of a hospital.In view of the nature of long and slow development cycle of medical talents,Wuxi No.2 People' s Hospital has innovated aTalent-tree program.This program develops talents by categories and stages,in the model oftree root-tree trunk-tree crownto fit different stage needs of these people.The program features a categorized education mode to establish hierarchical individualized plan for the whole career.The hospital has explored a special pathway for talents development,for the purpose of providing talents to ensure sustainable and innovative growth of the hospital.