Objective To investigate the efficacy of losartan combined with amiodarone in cardioversion of atrial fibrillation(AF)and maint of sinus rhythm in patients with paroxysmal AF.Methods From January 2003 to October 2005,a total of 86 consecutive patients with paroxysmal AF in 421 Hospital of PLA were randomly dividid into two group:group A(amiodarone,n=44)and.group B(amiodarone plus losartan n=42).The conversion of atrial fibrillation in 24 h,3 d and 7 d after therapy was investigated.The left atrial diameter was measured with transthoracic echocardiogram at before and after 6,12-months of treatment andyzed up to 12 months.Results The rate of cardioversion of AF is significantly higher in group A than group B at 7 d(86.36% vs 95.23%,P

Objective To investigate the expression and clinical significance of Survivin and Ki-67 in breast carcinoma,and explore their correlation.Method The expression of Survivin and Ki-67 in breast carcinoma(49 cases)and normal breast tissues(12 cases)were examined by immunohistochemical method.Results The positive expression rates of Survivin and Ki-67 in breast carcinoma were significantly higher than those in normal breast tissues(P<0.05).The expression of Survivin was significantly related to clinical stage and lymph node metastasis(P<0.05).The expression of Ki-67 Was significantly related to clinical stage,lymph node metastasis,and pathological grade(P<0.05).The expression of Survivin was obviously related with Ki-67 in breast carcinoma(r=0.734,P<0.05).Conclusions The overexpression of Survivin and Ki-67 may play a cooperative role in the occurrence and development of breast carcinoma.They may serve as useful markers for assessment of biological behavior of breast carcinoma.

Exosome is a self-secreted phospholipid bilayer nanovesicles, and has shown great potential in drug delivery field due to the important advantages of low immunogenicity and homologous targeting. Phototherapy, mainly includes photodynamic therapy (PDT) and photothermal therapy (PTT), utilize light to activate photoactive drug for tumor cell killing. The advanced therapeutic strategy shows low toxic side-effect and non-invasion precise advantages, and thus has made great progress in tumor treatment over the past few years. Therefore, using exosomes as a drug delivery system to deliver phototherapeutic agents can improve therapeutic performances with a reduced side-effect, and further enhance their application potential for clinical tumor therapy. This review focus on the rising cross-subjects field involving exosomes and phototherapy, and mainly introduce the research progress and relative case of exosomes-based delivery system for cancer phototherapy. Additionally, the advantages and challenges of exosome-based phototherapy are also discussed and proposed.

ObjectiveTo explore the protective effect of hearing protectors worn by noise-exposed workers and its influencing factors. Methods A total of 329 occupational noise-exposed workers were selected as the research subjects by judgment sampling method. A questionnaire survey on the use of ear protectors and individual suitability tests was conducted. Intervention was carried out for those whose personal attenuation rating (PAR) did not pass the baseline standard. Results The median (M) and the 25th and 75th percentiles of baseline PAR were 17.0 (5.0, 22.5) dB. The baseline PAR of the workers who were male, aged 25-<35 years, with a working experience of 5-<15 years, with a college degree or above, wearing ear protectors for 5-<15 years, knowing the right way to wear ear protectors, and workers who wore ear protectors correctly during work was relatively high (all P<0.01). The unqualified rate of baseline PAR of the study subjects was 32.8%. The unqualified rate of baseline PAR of workers in automobile manufacturing enterprises was lower than that of workers in plastic enterprises and textile enterprises (9.2% vs 43.6%, and 9.2% vs 50.0%, both P<0.01). The M of the 108 unqualified worker on baseline PAR was improved after intervention (22.0 vs 1.0 dB, P<0.01). The rates of knowing the right way to wear ear protectors, wearing ear protectors correctly during work, and receiving training on wearing ear protectors correctly for the research subjects were 88.1%, 84.8%, and 86.6%, respectively. Workers in automobile manufacturing enterprises and plastic enterprises had higher rates of knowing the right way to wear ear protectors, wearing ear protectors correctly during work, and receiving training on wearing ear protectors correctly than those in textile enterprises (all P<0.01). Conclusion Gender, age, working experience, education level, duration of wearing ear protectors, knowledge and use of ear protectors correctly are influencing factors of the protective effect of ear protectors for noise-exposed workers.

OBJECTIVETo study the factors affecting the management and treatment of immigrant workers with tuberculosis, to determine the most effective measures and to provide an academic basis for tuberculosis control and prevention strategies targeting the immigrant population.

METHODSA self-designed questionnaire was administered to 1364 immigrant workers with tuberculosis (study group) and 436 local residents (control group) with tuberculosis.

RESULTSWhether a patient's tuberculosis status was discovered or not was related to the medical facilities initially visited, job mobility, and the individual worker's economic condition. The percentage of cases discovered was relatively low among those who made their first visit to a private clinic (39.0%), and 58.4% (796) of immigrant workers delayed their first consultation mainly due to neglecting symptoms (55.9%, 445), subjective perception of symptoms being not severe enough (19.3%, 154) to visit a physician and the inconvenience of visiting a hospital because of its being far away from home (15.8%, 47). As comparing immigrant workers with local residents, the differences of the delay reason between the two groups were statistically significant (chi(2) = 21.49, P < 0.01). And 39.9% (544) of immigrant workers and 49.1% (214) of local residents had had late confirmation. The differences of the delay reasons between the two groups were insignificant (chi(2) = 7.31, P = 0.293). And 17.6% (240) patients of immigrant workers and 13.1% (57) patients of local residents did not keep to their drug regimens in a timely fashion. The differences of the reasons between the two groups were insignificant (chi(2) = 6.66, P > 0.05). And 77.5% (1057) of immigrant workers and 31.8% (138) of local residents were considered that taking medicine in supervision spot might have impact on their lives and work. The differences of the reasons between the two groups were significant (chi(2) = 9.71, P < 0.05). All 79.2% (1080) of immigrant workers and 63.3% (276) of local residents did not obtain medicine according to prescriptions. The differences of reasons between the two groups were statistically significant (chi(2) = 24.84, P < 0.01). And 51.2% (699) of immigrant workers and 46.1% (201) of the registered population did not follow up with doctors' directions for lab tests. The differences of the reasons between the two groups were insignificant (chi(2) = 3.26, P > 0.05).

CONCLUSIONThe influential factors in tuberculosis management and treatment were complex. Prevention strategies should focus on health education and promotion activities to improve awareness in seeking medical services. Also, developing and standardizing reference mechanisms for patients, and alleviating the economic burden of the workers will be critical to reduce the tuberculosis incidence.

China ; epidemiology ; Factor Analysis, Statistical ; Humans ; Transients and Migrants ; Treatment Outcome ; Tuberculosis, Pulmonary ; epidemiology ; prevention & control ; therapy ; Urban Population

OBJECTIVETo explore the effect of immune-enhanced enteral nutrition (IEN) together with recombined human growth hormone (rhGH) on patients after total gastrectomy.

METHODSForty-eight patients after total gastrectomy were randomly divided into EN group (n=16), IEN group (n=16) and IEN+ rhGH(n=16) group. Nitrogen balance, nutritional status, immune function and lassitude degree were compared among 3 groups.

RESULTSIEN+rhGH group had better efficacy as compared to EN and IEN group in improving postoperative nutritional status, immune function, nitrogen balance and lassitude degree, and recovered to normal level after 7 days. All the indexes of IEN+rhGH group except CD8 were improved significantly on the 10th day after operation as compared to those of EN group[total protein(66.8 +/- 2.0)g/L vs (65.8 +/- 0.9)g/L, CD3(66.1 +/- 6.3)% vs (60.5 +/- 5.6)%, Christensen score (4.6 +/- 0.9) vs (6.3 +/- 0.9), all P<0.05].

CONCLUSIONEarly application of IEN combined with rhGH plays an effective role in improving protein metabolism and immune function for patients after total gastrectomy in short period.

Aged ; Enteral Nutrition ; methods ; Fat Emulsions, Intravenous ; Female ; Gastrectomy ; Human Growth Hormone ; immunology ; therapeutic use ; Humans ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Recombinant Proteins ; immunology ; therapeutic use ; Stomach Neoplasms ; therapy

OBJECTIVETo study risk factors for severe hand, foot and mouth disease (HFMD) complicated by heart and lung failure and treatment experience.

METHODSA total of 198 children with severe HFMD between March and August in 2011 were enrolled. Univariate analysis and logistic regression model were used to analyze the risk factors severe HFMD complicated by heart and lung failure. The effects of combination therapy with immunoglobulin+dexamethasone+ribavirin were observed.

RESULTSUnivariate analysis indicated that HFMD patients with heart and lung failure had higher proportions of consciousness, tachypnoea, abnormal hemodynamics, increased troponin and EV71 infection than HFMD patients without heart and lung failure (P<0.05).Multivariate logistic regression analysis indicated that tachypnoea, abnormal hemodynamics and EV71 infection were the main risk factors for heart and lung failure. Compared with combination therapy with dexamethasone+ribavirin, combination therapy with immunoglobulin+dexamethasone+ribavirin was more effective for preventing hemodynamic changes in children with severe HFMD (P<0.01). Compared with HFMD patients with heart and lung failure, the effect of the combination therapy with immunoglobulin+dexamethasone+ribavirin was better in HFMD patients without heart and lung failure (P<0.01).

CONCLUSIONSThe main risk factors for heart and lung failure in children with severe HFMD include tachypnoea, abnormal hemodynamics and EV71 infection. Early combination therapy with immunoglobulin+dexamethasone+ribavirin can reduce the incidence of heart and lung failure in children with severe HFMD.

Child, Preschool ; Drug Therapy, Combination ; Female ; Hand, Foot and Mouth Disease ; complications ; Heart Failure ; drug therapy ; etiology ; physiopathology ; Humans ; Infant ; Logistic Models ; Male ; Respiratory Insufficiency ; drug therapy ; etiology ; physiopathology ; Risk Factors

OBJECTIVETo detect hot point mutations of ATP7B gene in Hunan Han patients with Wilson' disease (WD).

METHODSThe genomic DNA of 22 WD patients was extracted and exons 5, 8, 12, 13 were amplified by PCR. Screening for the mutations was done by direct sequencing and analysed by BLAST.

RESULTSFifteen of the 22 patients were found with mutations. Ten heterozygous Arg778Leu (2273G --> T) mutations were found in exon 8, all of them were accompanied with 2250C --> G polymorphism (Leu770Leu). Seven patients were found with 2855G --> A (Arg952Lys) polymorphism (4 heterozygous and 3 homozygous), 3 of them had Arg778Leu mutation in exon 8 and one with heterozygous mutation Gly943Asp (2828G --> A) in exon 12 simultaneously. Only one patient was found with heterozygous Pro992Leu (2975C --> T) mutation in exon 13. No mutations were found in exon 5.

CONCLUSIONArg778Leu is the hot point mutation of ATP7B gene in Hunan Han patients with Wilson' disease while exon 5 is not.

Adenosine Triphosphatases ; genetics ; Adolescent ; Asian Continental Ancestry Group ; genetics ; Cation Transport Proteins ; genetics ; Child ; Copper-transporting ATPases ; DNA ; genetics ; DNA Mutational Analysis ; Exons ; Hepatolenticular Degeneration ; ethnology ; genetics ; Humans ; Mutation

Objective To establish a quantitative RT-PCR method with self-quenched fluorogenic probe for detection of bcr/abl mRNA in patients with chronic myeloid leukemia for providing a useful tool for diagnosis of CML,evaluation of therapeutic effect and monitoring of minimal residual disease(MRD). Methods bcr/abl gene from cultured K562 cells was amplified by conventional RT-PCR.The standard quantitative plasmid was constructed by A-T clone method.The self-quenched fluorogenic quantitative RT- PCR method(FQ-RT-PCR)for determination of bcr/abl mRNA was established successfully using the ABI PRISM 7000 PCR Detector.The linear range,sensitivity,stability,and repetitiveness of the method were determined.The marrow samples from 25 CML patients and 3 ALL patients were assessed.Results The sensitivity of the FQ-RT-PCR was 10 copies/?l recombined plasmid,and bcr/abl mRNA can be detected from 1 K562 cell in 10~5 normal cells.The linear range was 10~2-10~9 copies/?l recombined plasmid.The coefficient variation(CV)value was 2.1% in intra-assay and 6.1% in inter-assay.The median ber/abl mRNA expression level was 4.50?10~4 copies/?g RNA [(0.45-89.00)?10~4],5.45?10~4 copies/?g RNA [(2.95-19.30)?10~4 ],13.00?10~4 copies/?g RNA [(4.10-89.00)?10~4] and 2.35?10~4 copies/?g RNA [(0.45-5.12)?10~4] in 25 CML patients,11 patients in the incipient chronic phase,6 patients in blastic crisis,8 patients in chronic period after treatment,respectively.The bcr/abl mRNA level in blastic crisis was significantly higher than that in chronic phase(q= 3.41,P

ObjectiveTo analyze the results of fit testing and its influencing factors on half-mask respirator among workers exposed to organic solvents. Methods A total of 84 workers exposed to organic solvents were selected as the research subjects using a convenience sampling method. The qualitative fit test apparatus of respiratory protection was tested after the workers had put on the half-mask respirats, and 11 facial indicators of the subjects were measured. Results The overall pass rate of the respirator fit testing was 71.4% (60/84). The lowest pass rate was 63.1% (53/84), which occurred during bending movements of workers. The head width, minimum forehead width, face length, nose length, nose depth, head circumference and head length were higher in workers who passed respirator fit testing, compared with those in the failing group (all P<0.05). The result of binary logistic regression analysis showed that gender and face width were influencing factors of the respirator fit testing (both P<0.05). Female workers had a lower pass rate of the fit testing than male workers, and workers with larger face width had a lower pass rate in the fit testing. Conclusion Drastic movement may lead to a decrease in the seal of half-mask respirator of workers exposed to organic solvents. When providing half-mask respirator to workers exposed to organic solvents, employers need to pay attention to the fit of respirators of female works and those with larger face width to ensure the effectiveness of respiratory protection for workers.