Adenoma ; pathology ; Carcinoma, Renal Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; pathology ; Middle Aged

Objective:To observe the efficacy and safety of Qingpeng ointment in the prevention and treatment of chemotherapeutic phlebitis. Methods:Totally 72 patients with non-small cell lung cancer undergoing chemotherapy after pneumonectomy were randomly divided into control and observation groups. The control group was treated with the conventional therapy to prevent phlebitis, and on the basis of conrentional therapy the observation group was treated with Qingpeng ointment at the injection site and along with the vein be-fore the chemotherapy, at the beginning of the chemotherapy, during the chemotherapy and after the chemotherapy in the same day and on the next day. The treatment course was 3 days. The incidence of phlebitis, hierarchical cases, VAS score and pain duration between the groups were compared, and the adverse drug reactions were observed. Results:The pain degree and duration induced by phlebitis showed no significant differences between the groups(P>0. 05), while the pain degree and duration in the observation group were de-creased when compared with those in the control group. The incidence of phlebitis in the observation group was obviously lower than that in the control group with statistically significant difference (P <0. 05). No adverse reactions were found with the external use of Qingpeng ointment. Conclusion:Qingpeng ointment has certain efficacy with high safety in the prevention of tumor-chemotherapeutic phlebitis, which can improve patients’ compliance, and is worthy of promoted application in clinics.

Objective To investigate the effect of restriction decision wheel and grade ICU patients with critical consciousness disorder. Methods Two hundred and fifty four patients in ICU with critical consciousness disorder from July to December 2012, who were intubated and constrained with their limbs due to the risk of unexpected extubation, were divided into the control group (n=125) and the experiment group (n=129), according to registration sequence. The former were constrained to their limbs after evaluation referring to the constraint nursing form and the latter was constrained by using the constraint decision-making wheel and grade. The two groups were compared in terms of restraint rate, unplanned extubation rate, and incidence of skin abnormality. Results The restraint rate of the observation group was significantly lower than that of the control group (P<0.01). There was no incidence of abnormal skin in the two groups. There was no significance in the rate of unplanned extubation between the two groups (P>0.05). Conclusion Constraints decision making wheel and grade is effective in ensuring patients'safety and improving the quality of nursing safety management by reducing unnecessary constraints or the incidence of delayed constraints.

Adult ; Diagnostic Errors ; Fatal Outcome ; Humans ; Male ; Pulmonary Alveolar Proteinosis ; complications ; Silicosis ; complications

Objective To investigate the role of activation of Akt/mTOR pathway in denfense against UVB-induced apoptosis in cultured human skin keratinocyte cell line HaCaT. Methods HaCaT cells were irradiated with UVB at different doses for various durations. Western blotting was performed to detect dynamic changes of Akt/mTOR pathway-related signaling molecule, such as phosphorylated-epidermal growth factor receptor (EGFR), -Akt, -4EBP1, etc; apoptosis was estimated by staining with DNA dye Hoechst 33342. To evaluate the role of signaling molecules in defense against UVB-induced apoptosis, HaCaT cells were pretreated before irradiation with EGFR inhibitor (PD153035), PI3K inhibitor (LY294002), mTOR inhibitor (rapamycin) followed by the detection of expressions of signaling molecule and apoptosis. Results UVB could activate Akt/mTOR pathway in a dose- (5 ～ 30 mJ/cm2) and time- (5 ～ 30 min) dependent manner. PD153035,LY 294002 and rapamycin could inhibit UVB-induced activation of the Akt/mTOR pathway. The apoptosis rate in HaCaT cells was upregulated by pretreatment with rapamycin and LY294002. Conclusion The activation of Akt/mTOR signaling pathway could inhibit the UVB-induced apoptosis in cultured HaCaT cells.

In total, 106 patients with maintenance hemodialysis (MHD) were divided into two groups based on their valsartan administration, and 53 healthy controls were recruited in the study. Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), resistin and high sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) before and after valsartan treatment. Plasma levels of resistin, IL-6, TNF-α and hs-CRP were all significantly increased in patients with MHD as compared to those in healthy controls (P＜0. 05). Among patients with MHD the plasma levels of resistin, IL-6 and hs-CRP in valsartan group were lower than those in non-valsartan group (P＜0. 05).

A rare case of anaplastic lymphoma kinase(ALK)-negative anaplastic large cell lymphoma (ALCL)with generalized cutaneous involvement is reported in a 37-year-old man.Seven months prior to the presentation,he developed a goose egg-sized mass in his right thigh without obvious triggers,which gradually grew and no significant discomfort was felt.Diffuse and nonpitting edema gradually appeared in his right thigh and hip.Two months prior to the presentation,multiple dark red papules,nodules,and plaques emerged over the body surface with erosions and ulcers of varying size arising on some of the plaques.Laboratory examination revealed reduced albumin and significantly elevated lactate dehydrogenase in serum.B-mode sonography showed swelling and mutual fusion of superficial lymph nodes,and color Doppler flow imaging revealed markedly increased branch blood flow signals in lymph nodes.Computed tomography(CT)displayed generalized swelling of lymph nodes associated with soft-tissue edema in the right thigh and perineal region,as well as extensive enlargement of epigastric and mediastinal lymph nodes.Pathological examination of the skin lesion revealed a dense dermal infiltrate with mononuclear cells,some of which presented with cellular atypia and atypical nuclear division.Immunohistochemistry of the skin lesion showed that the mononuclear cells stained positive for CD3,CD8,CD30(80％ positive),CD4,CD45RO and granzyme B,but negative for CD56,ALK and T cell intracellular antigen-1(TIA-1).Pathology of lymph nodes indicated that the lymph node structure was completely destroyed with a diffuse growth of tumor cells,which were larger than common large cell lymphoma cells,and contained basophilic or bi-color abundant cytoplasm,deviating,horseshoe-,kidney-shaped,or lobulated cell nuclei,sparse nuclear chromatin and single or multiple small basophilic nucleoli.Angiogenesis,stromal fibrosis and infiltration of varying number of plasma cells and lymphocytes were seen in pathological lymphoid tissue.Immunohistochemistry of lymph nodes showed that the tumor cells stained positive for CD2,CD4,CD3,granzyme B,epithelial membrane antigen(EMA),Ki-67 and CD30,but negative for CD8,CD56,TIA-1 and ALK.The patient was diagnosed with ALK-negative primary systemic ALCL with extensive cutaneous involvement.

Objective To compare the clinical outcomes of patients who underwent remnant-preserved anterior cruciate ligament (ACL) reconstruction with those who underwent conventional ACL reconstruction (ACLR).Methods From January 2010 to October 2012,93 eligible patients suffered from ACL injuries were randomly allocated into remnant-preserved group (ACLR with remnant preservation;n=48;Male/Female=34/14;Left/Right=25/23) and conventional group (ACLR without remnant preservation;n=45;Male/Female=33/12;Left/Right=22/23).The mean age of patients,time from injury to surgery,rates of combined meniscal injuries,and medial collateral ligament injury all showed no significant difference between the two groups preoperatively.All the patients underwent ACL reconstruction using 4-strand hamstring autografts.The postoperative assessments included knee functional scales (IKDC grade classification and Lysholm score),stability examinations (Lachman,pivot-shift,and KT-1000 arthometer),proprioceptive evaluations,and second-look arthroscopy.Results The average follow-up time was 25.4 months for the remnant-preserved group and 25.2 months for the conventional group.For IKDC grade classification,there were 32 patients with grade A,9 with grade B,1 with grade C in remnant-preserved group,whereas 30 with grade A,8 with grade B,2 with grade C in conventional group,which showed no significant difference between the two groups.Moreover,the Lysholm score (95.9±5.2 vs.95.4±1.7),Lachman test,pivot-shift test,KT-1000 arthometer (1.1±1.2 mm vs.1.2±0.9 mm),proprioceptive evaluations (joint position sense:3.6°± 1.8° vs.3.9°±2.2°) all showed no significant differences between the two groups.Additionally,the synovial coverage of grafted tendon under second-look arthroscopy was categorized as grade A in 11,grade B in 6,grade C in 2,grade D in 2 in remnant-preserved group,whereas grade A in 10,grade B in 5,grade C in 2,and grade D in 2 in conventional group,which still showed no significant difference.Conclusion In terms of the knee functional scales,stability examinations,joint position sense and graft synovial coverage,remnant-preserved ACLR group showed no superiority to the conventional ACLR group.

Objective To observe the clinical effects after implantation of an aspherical intraocular lens Acrysof IQ.Design Prospective,randomized concurrent-controlled study.Participants 64 patients(64 eyes)with bilateral senile cataracts.Methods Pa- tients were operated with phacoemulsification and IOL implantation.They were divided randomly into 2 groups according to the table of random number:one group with Aerysof IQ(aspherical IOL)implantation and the other with Acrysof SN60AT(spherical IOL).Thor- ough ophthalmic examinations,including visual acuity,slit lamp examinations,fundoseopy,wavefront aberrometry,contrast sensitivity, were performed 1 week,1 month and 3 months after surgery.Main Outcome Measures Visual acuity,the best corrected visual acuity, spherical aberration(C 12),the root mean square of the total higher-order aberration(RMSh),and contrast sensitivity at 4 kinds of light backgrounds.Results At 1 postoperative month,RMSh(0.30?0.68?m)and C12(0.07,?0.04?m)in aspherical IOL group were signifi- cantly lower than those of the spherical IOL group(0.49?0.14?m,0.36?0.06?m)(P=0.00)with a 6.0 mm aperture.At 3 postoperative months the RMSh(0.30?0.07?m)and C12(0.06?0.06?m)in aspherical IOL group were significantly lower than those of the spherical IOL group(0.47?0.14?m,0.34?0.06?m)(P=0.00)with a 6.0 mm aperture.The asphefieal IOL(Acrysof IQ)provided statistically sig- nificant better contrast sensitivity at all spatial frequencies under mesopic conditions(3 cd/m~2)with and without glare(P