Objective To study the role of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in extracellular matrix remodeling in rat model of chronic obstructive pulmonary emphysema .Methods Seventy Wistar rats were randomly subdivided into the control group and the smoking groups which were randomly subdivided into one month to six month smoking group again.The smoking groups were exposed to cigarette smoke for one to six months, The expressions of MMP-9 and TIMP-1 mRNA and proteins in lung tissue were detected by in situ hybridization and immunohistochemistry respectively.In lung tissue the expression of collagen Ⅳ was assessed by method of immunohistochemistry.Results Compared with the control group,the expressions of MMP-9 and TIMP-1 mRNA and proteins in lung tissue from the smoking groups were remarkable elevated(P

ObjectiveTo retrospectively analyze the relationship between clinicopathological,biological characteristics and the outcome of renal cell carcinoma(RCC) and evaluate the risk factors related to metastasis in young patients.MethodsThe data of 83 RCC patients younger than 40-year-old, treated from January 1986 to December 2007 in Tianjin Cancer Hospital,were analyzed retrospectively.The complete follow-up data of the 83 cases were collected.The operative methods included partial and radical surgery.Clinical staging were consistent with the 2004 UICC TNM classification criterion.The histological sections were reviewed.Various biological factors including VEGFR-1, VEGFR-2, VEGFR-3, PDGFR-α, PDGFR-β, c-kit and PCNA were tested by immunohistochemistry staining.The adjuvant radiation therapy, chemotherapy and immunotherapy after operation were carried out on the basis of pathological and biological features.The 83 cases were divided into two groups according to metastasis and non-metastasis status within 5 years.The prognosis related factors including clinical factors, pathological and biological factors were evaluated.Chi-square test was used for the analysis of 5-years metastasis status; and multivariate analysis was carried out using Cox proportional hazards models to assess the independent effect of the metastasis factors (the test standard α = 0.05).ResultsThe 5-year follow-up data showed that the metastasis rate in the 83 cases was 16.87％ (14/83).The Chi-square test results indicated that the patients with clinical stage Ⅲ and grade 3 had the highest metastasis rate (57.14％ and 78.57％respectively,x2 =38.042, x2 = 9.820; Ps ＜ 0.01) .The VEGFR-3 and PCNA positive expression rates were 92.86％ and 85.71％ respectively in metastasis group.The metastatic risk of early stage patients was 3.444 times as much as the advanced stage patients.ConclusionThe young patients with clinical advanced renal cell carcinoma had worse outcome.The stage,grade, VEGFR-3 and PCNA expression were the risk factors correlated with the metastasis risk for young RCC patients.TNM stage was an independent predictive risk factor of metastasis in young patients.

Objective:To seek the short term standardization study nurses training education content and the ap-proach to learning, provide theoretical basis for improving the study effect of nurse training.Methods:Choosing 3 ~6 months in 2014 in our hospital study questionnaire survey was conducted among 114 nurses, questionnaire by general in-formation, content of training needs, demand method of three parts and using SPSS19.0 to analyze the collected data. Results:The 82.7%of study nurses think pre-service training is very necessary.Pre-service training demand of the top three comprises:occupational protection (82.7%), health care, with communication skills (80.0%) and infection prevention and control (78.2%).Refresher training needs during the top three in turn:specialized rescue of critically ill patients and cooperation (88.2%), clinical application and nursing adverse event processing (79.1%), effective communication nurses and patients (79.1%).Demand content score between the different degree and the title of ad-vanced nurse was statistically difference (P<0.05).The training methods, in the first three order practice (89.10%), seminar (74.5%), case analysis and discussion (67.30%).Conclusion:According to the study demand of nurse stand-ardized training content and ways of learning, considering the influence factors such as education, job title, targeted training plan, improve the effect of short-term training.

OBJECTIVE: To investigate the clinical features and operation treatment of the congenital middle ear cholesteatoma. METHOD: A retrospective review of clinical and surgical records of 10 patients with congenital middle ear cholesteatoma were performed. All patients were treated by surgeries,5 of 10 cases deal with one-stage tympanoplasty after drum exploration by external auditory meatus, 3 cases dealed with closed mastoidotympanectomy and tympanomastoidectomy, 2 cases dealed with open mastoidotympanectomy and tympanomastoidectomy. RESULT: The cholesteatomas were located at or around the posterior tympanum or mesotympanum in 5 patients, confined to the tympanic cavity and attic in 3 patients, advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 2 patients. The mean postoperative PTA was 30 dB HL, the mean ABG was within 20 dB, after six months. No residual or recurrence of cholesteatoma was found. CONCLUSION The congenital cholesteatoma often originates from the posterior or anterior of the middle ear, with hiding lesion, thus result in severe conductive hearing loss. Imaging examination plays an important role in diagnosing and treating of congenital cholesteatoma. Early stage surgical treatment can obtain a good hearing reconstruction effect.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; congenital ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Tympanoplasty ; methods ; Young Adult

Objective To study the effect of cardiac troponin T(cTnT)on the prognosis of chronic heart failure in the elderly patients.Methods Serum level of cTnT,and serum activities of creatine kinase (CK)and creatine kinase-MB(CK-MB)were measured in 60 elderly patients of chronic heart failure with varied classes of cardiac function.Cardiac events,including malignant cardiac arrhythemia,repeated or aggravated heart failure or cardiac death,in patients with increased cTnT during hospitalization were compared to those without it.Results Serum level averaged(89.1?13.6)mmol/L for CK and(7.9? 1.4)mmol/L for CK-MB in 20 patients with Class Ⅱ cardiac function by New York Heart Association (NYHA)classification and without increased cTnT,(88.2?13.4)mmol/L for CK and(7.5?1.8) mmol/L for CK-MB in 19 patients with Class Ⅲ cardiac function and four of them with increased cTnT,and (93.3?14.2)mmol/L for CK and(8.1?1.6)mmol/L for CK-MB in 21 patients with Class Ⅳ cardiac function and 14 of them with increased cTnT.Malignant cardiac arrhythemia occurred in six,repeated heart failure in eight,and death in three of 18 patients with increased cTnT,and one,two and one in 22 patients without increased cTnT,respectively.Incidence of cardiac events was higher in patients with increased cTnT than those without it(P

OBJECTIVE To evaluate the clinical curative effect and safety of rifaximin in treating acute infectious(diarrhea).METHODS A multi-center randomized trial with double-blind double-analogue and parallel(-control) with positive drug was used.All the 240 chosen patients were classified into two groups.There were 120 cases in the trial group.On the first day,the patients received rifaximin 300mg tid.From the 2nd to 5th day,the patients(received) rifaximin 400 mg tid.There were 120 cases in the control group,on the first day,the patients received levofloxacin 100 mg tid;from 2nd to 5th day,they received levofloxacin 100 mg tid.The total therapeutic course was 3 to 5 days.RESULTS After 3-5 day treatment,symptoms such as ache in abdomen and diarrhea were(alleviated) or disappeared and stool examination was turned better or normally.To the trial group,the cure rate was 84.68%,the dominant effecive rate was 15.31%,and the total(effective) rate was 100.00%.The bacteria clearance rate was 100.00% in the trial group.There was no significant difference between two groups.There were no severe side effect in the two groups.CONCLUSIONS Rifaximin is an effective and safe drug for acute(infectious) diarrhea for adults.

Objective:To standardize the clinical information of the nose.Methods:Based on the 1034 descriptions on the clinical manifestation of nose in the database of the clinical records of Chinese medicine in the past dynasties,according to the hypothesis of symptomatic unit,the symptomatic units,the second-level clinical characteristics and the limiting factors were summarized in the paper.Results:All the descriptions on the clinical manifestation of nose include 11 symptomatic units,7 second-level clinical characteristics and 1 limiting factor.Conclusion:Comparing with the symptoms in the authoritative works of Chinese medicine,cold-feeling of the nose while breathing was the new fi nding,nares flaring and ozena recorded in the authoritative works were the second-level clinical characteristics of polypnea and rhinorrhoea respectively.Nose diseases,such as nasal eczema,were usually diagnosed by several symptomatic units,so they were not symptomatic units.

Objective To develop a superparamagnetic iron oxide (SPIO)-based MR probe containing vascular endothelial growth factor(VEGF) to investigate their biological and chemical properties and targeting effect of colorectal cancer cells in vitro. Methods The anti-VEGF-SPIO probe was fabricated with VEGF antibody and SPIO through chemical method. Its biological and chemical properties and reflexivity were tested with SDS-PAGE and MRL The SW620 cells incubated with anti-VEGF-SPIO probe for 30, 60 and 90 minutes respectively and compared with marrow mesenchymal stem cell at 37℃. The comparison among groups was conducted by using analysis of variance and LSD-t test. The MRI results were confirmed by the Prussian blue staining. The comparison among groups was performed by analysis of variance and factorial experiment. Results SPIO-based MR probe containing VEGF was successfully contributed and isolated. The reflexivity of anti-VEGF-SPIO probe was 0.0426×10~6 mol/s. The immunofluorescence and prussia blue stain proved high expression of VEGF in SW620 cells. Anti-VEGF-SPIO probe and SW620 cellscombined at 37℃ in vitro MRI proved the SW620 cells incubated with anti-VEGF-SPIO probe appeared hypointense on T_2WI and T_2~* WI. MR signal were 392±7,91±8,264±10 for 30, 60 and 90 minutes respectively, which were statistically different from that before incubation 679±12 (F=4735.489, P< 0.01). The intensity decreased most significantly at 60 minutes in vitro. Its MR signal 82±7 were statistically different compared with marrow mesenchymal stem cell 689±43, t=39.167,P<0.05). While SW620 cells incubated without SPIO were not statistically different compared with marrow mesenchymal stem cell, which were 419±59 and 400±41 respectively(t=-0.718,P>0.05). Conclusion Nanoscale iron particles containing the anti-vascular endothelial growth factor molecular probe can evaluate tumor angiogenesis at the receptor level, which provides a new way of the tumor angiogenesis diagnosis and anti-angiogenesis therapy.

OBJECTIVE:To study the quality control,stability and therapeutic effect of compound fleroxacin ear-drops.ME_THODS:The content of fleroxacin in the ear-drops was determined by ultraviolet spectrophotometry.RESULTS:There was a good linearity in a range of concentrations from 2?g/ml to 12?g/ml,r=0.9 998,average rate of recovery was 100.38%,RSD=0.39%(n=6).The preparation showed stable quality and satisfactory effect.CONCLUSION:This ear-drops is simple in preparation,reliable in quality-control and effective in clinical use.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.