Health Facilities ; Humans ; Medical Waste Disposal ; methods ; standards ; Public Health Practice ; standards

Adult ; Child ; Diet ; Female ; Fetus ; immunology ; Humans ; Hypersensitivity ; embryology ; immunology ; Maternal Behavior ; Pregnancy ; immunology ; Risk Factors

Acute and chronic graft rejection are the major factors leading to graft non-function.There is an active expression of chemokines early after transplantation.They recruit T cells and antigen presenting cells selectively to the graft, leading to inflammatory reaction and finally to graft non-function.Accordingly,monitoring the expression status of chemokines and their receptors regularly may help to the diagnose rejection.To determine one or more chemokines or their receptors as the new targets for anti-rejection therapy will be of great clinical significance.This review focuses on the research progression in the above areas.

Objective To assess the quality of life(QOL)in patients with stroke at the acute stage,and to determine whether all the dimensions of the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)are applicable to the stroke patients.Methods Fifty stroke patients at the acute stage were studied.The SF-36 was employed to assess the quality of life of the patients,and a self-designed questionnaire was used to record the general information of them.The data obtained from the patients was compared with the Chinese norm reported in literature. We also calculated the percentage of subjects who achieved the lowest possible score(score of 0,floor effect)and the percentage of subjects who achieved the highest possible score(score of 100,ceiling effect).Results The QOL of the acute stroke patients,as reflected by scores with all the dimensions of the SF-36 scale,was significantly reduced when compared with the norm data(P

Objective To explore the relationship between tumor necrosis factor(TNF)-? promoter G238A,G308A and interferon(IFN)-?+874A/T polymorphism and susceptibility to cytomegalovirus(CMV) hepatitis.Methods A TaqMan fluorescence polymerase chain reaction(PCR) in the IFN-?+874A/T and TNF-? gene promoter region single nucleotide polymorphism was tested in the subjects,including 87 infants with CMV hepatitis and 89 children without CMV hepatitis.Results No evident difference of TNF-? +238G/A and+308G/A allele frequency was found between infants with CMV hepatitis and controls.The cases of IFN-?+874 AA,AT and TT genotype were 64,20,3 cases in the infant CMV hepatitis group,and 45,26 and 18 cases in the control group,respectively.There was significant difference in IFN-?+874 allele genotype and frequency between infants with CMV hepatitis and the control group(P=0.001,P

Objective To investigate the significance of CerbB-2 oncogene in the occurrence and development of gastric adenocarcinoma. Methods By using immunohistochemistry and fluorescence in situ hybridization, 60 cases of gastric adenocarcinoma tissue, 60 cases of normal margin of mucosal tissue and 30 cases of normal gastric mucosa tissue were detected for the expression and amplification of CerbB-2. Results The positive rate of CerbB-2 expression in gastric adenocarcinoma tissues, normal margin of mucosal tissues and normal gastric mucosa tissues were 31.7 %, 8.33 % and 3.33 %; The positive rate of CerbB-2 amplification of these were 28.3 %, 5 % and 0. There were significant differences between gastric adenocarcinoma tissues and the others in the expression and amplification of CerbB-2. The expression and amplification of CerbB-2 in gastric adenocarcinoma tissues had no correlation with age,gender,tumor size or tumor differentiation degree of patients' (P >0.05), but were correlated with the extent of tumor invasion, lymph node metastasis, distant metastasis and clinical stage(P <0.05). Conclusion CerbB-2 is closely related to the occurrence and development of gastric adenocarcinoma, and can be considered as an important index for determining the biological behavior of gastric cancer.

Scientific research management has become a crucial work in each hospital.The quality of scientific research management directly affects the level of scientific research development.Scientific research secretaries act as the direct participants and grassroots community of scientific research management,whose strengths and weaknesses of development related to the level of scientific research management directly.This study put forward several countermeasures on the barriers of hospital scientific research secretaries development,aiming to promote the development of hospital's scientific research and discipline construction.

OBJECTIVETo investigate the clinical application of pedicled superficial circumflex iliac artery (SCIA) flaps in Burns and Plastic Surgery.

METHODS19 cases with skin and soft tissue defects were repaired with the Superficial circumflex iliac artery flaps. The defects located in the hand and forearm, the lower abdomen and perineal area, the radicle area of thigh, etc. Before the SCIA flaps were transfered to the recipient areas, 15 cases with different kinds of wounds were debrided thoroughly, 3 cases with scar were removed directly. The size of the flaps ranged from 3.0 cm x 4.5 cm to 26.0 cm x 22.0 cm, and the pedical was 5 cm to 7 cm in length.

RESULTSThe flaps in the 18 cases survived completely. Skin necrosis in the distal end of the flap appeared in 1 case, and the wound healed after the second repair. The follow-up period rang from 3 to 18 months. The apperance and function of the hand or foot was satisfactory.

CONCLUSIONSBecause the pedicled SCIA flaps can be obtain conveniently and contain sufficient blood-supply, so the flap is easy to survive and the flap can be designed in a large size. We believe it is an ideal method to use this flap to repair skin and soft tissue defects located in hands, forearms, the lower abdomen and perineal areas, the radicle area of thigh and so on.

Burns ; surgery ; Forearm ; Graft Survival ; Hand ; Humans ; Iliac Artery ; Necrosis ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; pathology ; transplantation ; Thigh ; Wound Healing

BACKGROUND: It has been reported tbat there are rich expressions of serotonin transporter (5-HTT) in the cortical and limbic regions related to emotion and behavior in cerebrum. Regulation of the intensity and persistence of serotonergic nerve response can change the serotonergic neurotransmission, meanwhile, 5-HTT is also an important target for selective serotonin reuptake inhibitors (SSRIs).OBJECTIVE: To observe whether there is a correlation of 5-HTT gene polymorphism with plasma level of 5-HT and the clinical response of SSRIs in the population of Nanjing area.DESIGN: A case-control observation.SETTING: Department of Psychiatry, Brain Hospital of Nanjing Medical University.PARTICIPANTS: Totally 132 inpatients with depression in the Department of Psychiatry, Brain Hospital of Nanjing Medical University and 100 volunteer healthy blood donors were taken as the observational subjects between January 2001 and December 2003.METHODS: The genotype was analyzed with polymerase chain reaction (PCR) polymorphism analysis in the patients with depression and healthy subjects; plasma level of 5-HT was analyzed with high performance liquid chromatography-electrical chemistry detector (HPLC-ECD); and the clinical response to the antidepressants were assessed with Hamilton depression rating scale (HAMD).MAIN OUTCOME MEASURES: The analytical results of 5-HTT genotype frequency and allele frequency in both groups, and the relationship between 5-HTT genotype and plasma level of 5-HT before and after SSRIs treatment were observed.RESULTS: Blood samples were collected from all the 132 patients with depression and 100 normal healthy subjects, and they all finished the scale test and entered the analysis of results. ① There were no significant differences between the depression group and normal control group in the 5-HTT gene genotype frequencies (LL: 24.2%, LS: 44.7%, SS31.1%; LL:29.0%, LS: 47.0%, SS: 24.0%, x2=1.405 8, P ＞ 0.05) and allelefrequencies (L:46.59%, S: 53.41%; L: 52.5%, S: 47.5%, x2=0.696 2, P ＞ 0.05). ② The total score of HAMD had significant differences before treatment among the depressive patients of different genotypes (F=6.48, P=0.002 1). After 4-week treatment of SSRIs antidepressants, the total score of HAMD was significantly decreased, and there was significant difference in the decrease of score (F=3.38, P= 0.037). ③ The plasma level of 5-HT had significant differences before treatment among the depressive patients of different genotypes (F=5.38,P= 0.005 7). After 4-week treatment of SSRIs antidepressants, the plasma level of 5-HT was increased, and the increased level was significantly different among different genotypes (F=23.55, P ＜ 0.01).CONCLUSION: The 5-HTT polymorphism may be not associated with the attack of depression, but with the severity of depression and the clinical responses of SSRIs in the population of Nanjing area, and the genotype in this area may become a reference index for the realization of individualized treatment in patients with depression.

BACKGROUND: Monoamine hypothesis has been demonstrated by researches. However, the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression has less been reported.OBJECTIVE: To study the effect of different drugs on metabolite of plaama monoamine neurotransmitter, and the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression.DESIGN: Case controlled study.SETTING: Neurological Department and Brain Institute of Nanjing Medical University.PARTICIPANTS: Forty patients with depression hospitalized in Nanjing Brain Hospital (depression group) were diagnosed with the second revised edition of China classification of mental diseases(CCMD-2) and the tenth edition of International classification of diseases. And the total score of Hanmilton rating scale for depression(HAMD) was more than 17. Healthy voluntary blood donators in the control group were from Nanjing Municipal Central Blood Station( n = 20).INTERVENTIONS: Antidepressant was used in the depression for 4 weeks: fluoxetine 20 mg per day; 5-serotonin selective reuptake inhibitor (SSRI) paroxetine 20 mg per day; venlafaxime 50- 100 mg per day;5-serotonin and morepinephrine selective reuptake inhibitor(SNRI) fluvoxamine 50-100 mg per day. High performance liquid chromatograpy(HPLC)was used to measure the level of metabolite of plasma monoamine neurotransmitter in patients with depression before and 42 week after treatment, and the HAMD was used to evaluate clinical effect of the patients.MAIN OUTCOME MEASURES: The levels of metabolites of plasma monoamine neurotransmitters in patients with depression: 5-hydroxyindoleace tic acid(5-HIAA), 3-methoxy-4-hydroxyphenylglycol(MHPG) and homovani llic acid(HVA) were measured before and 4th week after treatment.RESULTS: The levels of 5-HIAA, MHPG and HVA of the metabolites of plasma monoamine neurotransmitters in patients with depression before treatment [ (20.3±14.6), (124.8±103.6), (54.7±32.1) μg/L] were all lower than those in the normal control group[ (39.5±28.4), (334.5 ±107.3), (88.5±37.2) μg/L], with statistically significant differences (P＜0.05). After SSRI treatment, the 5-HIAA content[ (37.1±21.9)μg/L]was significantly increased as compared with that before treatment, whose difference indicated significant meaning ( P＜0.05), but the differences in MHPG and HVA had no significant meaning as compared with those before treatment(P＞0.05) . After SNRI treatment, 5-HIAA and MHPG contents [(35.4±25.2 ), (291.2±120.4) μg/L] both were significantly increased, which indicated significant difference as compared with those before treatment( P＜0.05); but HVA level had no significant changes.CONCLUSION:'The peripheral neurotransmitter metabolites in plasma can reflect their states in brain. The change of neurotransmitter metabolite in plasma can be regarded as an important reference index for the evaluation of depression.