Objective To analyze catheter-related bloodstream infections due to Rhizobium radiation (R.radiobacter) in pediatric patients.Methods Clinical data of 1 014 pediatric patients with intravascular catheterization were collected from February 2012 to February 2014,including age,length of time a catheter remained in place,laboratory findings and outcome of R.radiobacter bloodstream infection in order to explore the factors for R.radiobacter infection.Results There were 26 children contracting R.radiobacter bloodstream infection children,and of them,21 were under 2 years old (80.77％),and the length of time for catheter dwelt in vessel longer than 5 days in 20 children (76.92％).There were significant differences in age under 2 years old,length of time longer than 5 days for catheter remained in place,CD4 and CD4/ CD8 between 26 children with R.radiobacter infection and uninfected children (P ＜ 0.01).The re-infection with different varieties of bacterial strains was found in 12 of all R.radiobacter infection children (46.15％) after treatment,and of them,R.radiobacter bloodstream infection was detected twice in 2 children,and 2 died (7.69％).Conclusions Age under 2 years old,the length of time for intra-vascular catheter remained in place longer than 5 days,and weakened immunity are the important risk factors of R.radiobacter bloodstream infection,and the improper medical care may be the cause of re-infections in pediatric patients with prolonged intra-vascular catheter-dwelling.

Objective To investigate the effect of radiotherapy combined with interventional therapy on the changes of vascular endothelial growth factor (VEGF) in patients with advanced cervical cancer.Methods 62 cases of cervical cancer collected in the first people’s hospital of jingzhou city during January 2009 to February 2014 were randomly divided into two groups.The patients in group A were treated with radiotherapy, and the patients in group B were treated with radiotherapy combined with interventional therapy.The level of vascular endothelial growth factor in two groups after treatment was measured by enzyme-linked immunoassay.Results The level of vascular endothelial growth factor of group A was ( 241.77 ±85.86 )μg/L, significantly higher than ( 124.66 ±65.86 )μg/L of group B.The level of vascular endothelial growth factor was related with cervical deterioration degree, tumor stage and lymph nodes metastasis (P<0.05),not with the patient’s age, and the size of the tumors.The level of vascular endothelial growth can reflect the clinical efficacy of patients after therapy (P<0.05).Conclusion Vascular endothelial growth factor level has a close relationship with the degree of deterioration of cervical cancer, tumor staging, lymph node metastasis and the curative effect after the interventional therapy.

Objective: To study the pharmacokinetics of f1omoxef(Fmox) in 8 hea1thy volunteers after infusion of 1 gFmox injection. Methods: Fmox concentrations in plasma and urine were measured by an improved HPLC method. Results:The results showed that peak plasma level (cmax), terminal phase plasma elimination half-life (t1/2?), volume of distribution(Vc ), clearance (CI3)and area under plama concentration-time curve (AUC)were (56.15?13.16) ?g/ml, (1.29?0.32) h,(13. 11?12. 06) L, (16.02?1.88) L/h and (64.86?4.93)?g? h/ml respectively. Conclusion: Drug concentrations-time pro-file of Fmox conforms to a two-compartment open phartnacokinetic model. Fmox is mainly excreted through kidney in un-changed form. The cumulative urinary excretive rate of Fmox is (79. 39l4. 01) % 8 h after administration.

Objective To investigate the distribution of pelvic recurrence in rectal cancer after radical resection and analyze the outcome and prognostic factors of pelvic recurrent rectal cancer treated with radiotherapy. Methods Ninety-three patients with pelvic recurrent rectal cancer who received radiotherapy from August 2000 to August 2006 were retrospectively analyzed. Of them, 21 patients received pelvic radiation alone;56 received pelvic radiation plus chemotherapy and 16 received pelvic radiation plus surgery and/or chemotherapy. Radiotherapy was delivered with 60Coγor 6/15 MV X ray to a median dose of 59. 4Gy (range,20-74 Gy). Conventional fractionation was used in 90 patients. Chemotherapy was given to 68patients with a median number of 3 cycles ( range, 1 - 8 cycles). Concurrent chemo-radiation with 5-FU based regimen was given to 42 patients. After radiotherapy, 16 patients underwent surgical resection, with 7R0 resection and 9 palliative resection. Results The entire cohort included 132 recurrent sites. The most common recurrent sites were peri-rectal region ( 31.8% ), pre-sacral region ( 30. 3% ) and internal iliac nodal region (20. 2% ). The follow-up rate was 92% for the entire cohort, 39 and 4 patients had minimum follow-up time of 2 and 5 years respectively. Overall clinical response ( complete and partial symptomatic relief) was achieved in 83% of the patients after radiation therapy. The 2-and 5-year local progression-free survival rates were 49% and 22% respectively, and the 2-and 5-year overall survival rates were 46% and 14% respectively. Multivariate analysis showed that treatment modality was the independent prognostic factor for local progression-free survival. Patients treated with radiation plus surgery and/or chemotherapy had better local progression-free survival than those treated with radiation plus chemotherapy or radiation alone.Recurrent tumors larger than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were independent unfavorable prognostic factors for overall survival. Conclusions Perirectal region, pre-sacral region and internal iliac nodal region were the most common pelvic recurrent sites in rectal cancer. Radiotherapy is an effective palliative approach for patients with pelvic recurrent rectal cancer.Radiotherapy plus surgery and/or chemotherapy was associated with better local progression-free survival,and recurrent tumors lager than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were unfavorable prognostic factors for overall survival of pelvic recurrent rectal caner.

Functional magnetic resonance imaging (fMRI), a newly developing technique, contains function, anatomy and image, which makes the real-time, dynamic and non-invasive measurement of the functional brain imaging availability. This paper summarized the characteristics of fMRI in health and stroke populations, introduced the advances of fMRI in neuroplasticity, rehabilitation assessment and prognosis in hand movement dysfunction in patients with stroke, and discussed the difficulty fMRI faced in rehabilitation assessment and the further researches.

·Cataract refers to the degenerative changes in lens quality caused by various causes of reduced transparency or color change. Surgical treatment is the main treatment modality at present. Among them, phacoemulsification has become the main surgical treatment for cataract because of its advantages such as short operation time, small incision and quicker healing. Today, cataract surgery has gradually shift to refractive surgery, and is no longer simply as cataract surgery. But after cataract phacoemulsification, the symptoms and visual quality are different. The main causes include refractive error, postoperative dry eyes and postoperative corneal astigmatism. This article reviews the factors that influence the visual quality of cataract phacoemulsification and its future trends.

According to the current situation of biochemistry teaching and the theoretical characteristics of constructivism,the necessity and feasibility of applying constructivism to the biochemistry teaching were analyzed.Consequently,the implementation strategies of constructivism theory in the process of biochemistry teaching were introduced in detail.Through the reasonable choice of teaching content and the optimal combination of various teaching methods,it was helpful not only to realize the student-centered active construction of knowledge,but also to improve the comprehensive quality of students.At last,we performed a dialectical thought on the constructivism theory.In the concrete teaching practice,the different teaching theories should be used rationally and comprehensively based on the actual situation to improve the teaching quality of biochemistry.

BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insufficiency (CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit (ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group (n=32) and a control group (n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone (150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers of inflammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically significant. RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4％. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI (23.8％ vs. 8.7％, P<0.01). Kaplan-Meier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group (P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group (18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers of infection and inflammation (P<0.01), such as C-reactive protein (13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α (26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin (3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group (P<0.01). CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers of infection and inflammation.

Objective:To study the clinical effects of Yishen-Shengxue Decoction on the prevention and treatment of bone marrow suppression in acute myeloid leukemia after chemotherapy. Methods:A total of 60 patients in Beijing Longfu Hospital from June 2018 to March 2020 were randomly divided into control group and observation group, 30 cases in each group. The control group was treated with western medicine and blood transfusion, while the observation group was treated with Yishen-Shengxue Decoction on the basis of the control group. Both groups were treated for 2 weeks. We recorded the occurrence time and duration of Ⅳ degree myelosuppression of the two groups, compared the score of symptoms and signs, injection volume of recombinant human granulocyte colony stimulating factor (G-CSF) and blood transfusion volume, and recorded the incidence of adverse reactions after chemotherapy. Results:The occurrence of myelosuppression in the observation group was significantly later than that of the control group (5.07 ± 0.87 d vs. 3.83 ± 1.15 d; t=4.695, P<0.01), and the duration of grade Ⅳ myelosuppression was significantly shorter than that of the control group (7.20 ± 0.76 d vs. 10.03 ± 1.30 d; t=10.305, P<0.01); The quantity of granulocyte colony stimulating factor injection in the observation group was significantly less than that of the control group (7.2 ± 0.8 vs. 10.0 ± 1.3, t=10.305), and the quantity of red blood cell suspension (2.5 ± 1.5 U vs. 4.7 ± 1.5 U, t=7.749) and platelet transfusion (1.7 ± 0.5 U vs. 3.1 ± 0.9 U, t=5.879) were significantly less than that of the control group ( P<0.01); the quantitative score of symptoms and signs in the observation group were significantly lower than thoseof the control group ( t values were 18.208, 15.129, respectively, all Ps<0.01). The adverse reactions of the patients in the observation group after chemotherapy were significantly less than those of the control group, and the incidence of infection, bleeding and ECG abnormalities were statistically significant ( χ2 values were 7.500, 10.000, 4.286, respectively, all Ps<0.01). Conclusion:Yishen-Shengxue Decoction is helpful to delay the occurrence of myelosuppression, and promote its recovery, reduce various adverse reactions during myelosuppression, and improve the quality of life.

Objective To investigate the clinical characteristics, the association with the risk factors of macrovascular complications, the prevalence of microvascular complications between LADA patients and Type 2 diabetes(T2DM). Methods A cross-sectional study of 30 cases of LADA(ICA positive) patients and 60 cases of ICA negative T2DM subjects matched with age, sex and duration.Results As compared with T2DM, LADA cases showed a lower BMI(21 3?0 5 vs 23 3?0.4kg/m 2, P