Objective To investigate the morbidity and cause of post-operative complications and quality of life for cervical carcinoma.Methods 100 patients were analysed retrospectively.The methods of operation included:class Ⅰ,20 cases;Class Ⅱ,20 cases;Class Ⅲ,20 cases;Class Ⅳ,40 cases.The quality of life in 68 patients with cervical cancer who received radiotherapy were evaluated.Results The common complications were in urinary system,including 26.0% of infection,25.0% urine retention and 3.0% fistula.And the other complications included 2.0% of incision infection,1.0% of lung infection,1.0% of pelvic infection and 1.0% of death related with operation.Multivariate analysis revealed that factors contributing to QOL were pain and depression before radiotherapy,nausea and vomiting during radiotherapy.Conclusions The some surgical modifying could decrease the morbidity of urinary infection and fistula.The quality of life in cervical carcinoma is affectd by multiple complex factors.

Objective To investigate the distribution of pathogens isolated from lower respiratory tract sputum samples of trach‐eotomy patients who suffered from severe craniocerebral injury and nurses′hands surface samples ,and analyze the correlation be‐tween them .Methods Lower respiratory tract sputum samples of 97 tracheotomy patients suffered from severe craniocerebral inju‐ry and hands surface samples from nurses who just washed their hands after the sample collection were collected .Then the samples were sent to the microbiological lab for pathogen isolation and identification ,the results were statistically analyzed by using WHO‐NET5.4software.Results 388sampleswerecollectedaltogether,including194sputumsamplesand194nurses′handssurface samples .633 pathogens were isolated altogether ,including 452 strains of G- bacteria (71 .41% ) ,134 strains of G+ bacteria (21 .17% ) and 47 strains of fungi(7 .42% ) .The top five species of G- bacteria which took the largest proportion and caused the lower respiratory tract infection were Peudomonas aeruginosa(12 .16% ) ,Acinetobacter baumannii(9 .63% ) ,Klebsiella pneumoniae bacteria(7 .10% ) ,Stenotrophomonas maltophilia(5 .21% ) ,Escherichia coli(4 .89% );the primary species of G+ bacteria were coag‐ulase negative staphylococcus(6 .79% ) ,Staphylococcus aureus(2 .36% );the primary fungus was Monilia albicans(4 .24% ) .The top five G- bacteria species which took the largest proportion and isolated from hands surface samples were Pseudomonas aeruginosa (6 .79% ) ,Acinetobacter baumannii(5 .84% ) ,Escherichia coli(4 .91% ) ,Klebsiella pneumoniae(3 .94% ) ,Stenotrophomonas malto‐philia(3 .79% );the primary species of G+ bacteria were coagulase negative staphylococcus (9 .63% ) ,Staphylococcus aureus (2 .36% ) .The primary fungus was Monilia albicans(3 .00% ) .Conclusion Tracheotomy patients who suffered from severe cranio‐cerebral injury with lower respiratory infection are very possible to have cross‐infection ,sanitary management of nurses′hands asep‐tic manipulation procedures should be strengthened .

Objective To compare the effect of cisplatin or nedaplatin combined with paclitaxel as an adjuvant chemotherapy for cervical cancer.Methods Total 160 patients with cervical cancer in Ningqiang County Tianjin Hospital from February 2011 to December 2015 were divided into two groups according to different treatments.Cisplatin group was treated with TP chemotherapy,nedaplatin group was treated with TN chemotherapy,the curative effect,adverse reaction of chemotherapy,hospitalization time and treatment costs were compared between the two groups.Results The effective rate of cisplatin group was 79.26％ and nedaplatin group's was 82.05％,the two groups had no significant difference;The incidence of Ⅰ-Ⅳ grade hemoglobin,leukocyte of nedaplatin group were significantly higher than those in the cisplatin group (P ＜ 0.05),but between the two groups Ⅲ and Ⅳ grade had no significant difference,the incidence of Ⅰ-Ⅳ grade and Ⅲ-Ⅳ grade nausea,vomiting of nedaplatin group were significantly lower than cisplatin group (P ＜ 0.05);The hospitalization time of nedaplatin group was significantly shorter than cisplatin group (P ＜ 0.05),The cost of treatment between nedaplatin group and cisplatin group had no significant difference.Conclusion Cisplatin or nedaplatin combined with paclitaxel has similar efficacy in the neoadjuvant chemotherapy for cervical cancer,gastrointestinal adverse reactions of nedaplatin are lower than cisptatin,bone marrow suppression increase but still can be controlled,nedaplatin chemotherapy can shorten the duration of hospitalization,and hospitalization expenses were not significantly increased,which makes it more easily accepted by patients.

Objective Hyperglycemia was common during acute myocardiai infarction (AMI). This study investigated the impact of stress hyperglycemia on in-hospital outcomes in patients without diabetes hospitalized with AMI. Methods The study included 107 patients with AMI without diabetes, who were admitted to 81 hospital of PLA of Nanjing, China from January 2000 to May 2010. The in-hospital mortality and in-hospital complications were analyzed retrospectively. The exclusion criteria were: (1 ) patients < 18 years old; (2) patients with history of diabetes; (3) patients who initiated anti-hyperglycemic therapy during their hospital stay though without previously diagnosed diabetes; (4) patients with non-cardiovascular causes for AMI; (5) patients with hepatic failure, kidney failure, serious lung illnesses and end stage of malignant tumour; (6) patients administrated with steroid treatment recently and those with some diseases which had dramatic effect on glucose metabolism such as hyperthyroidism and cushing syndrome. Patients were categorized according to FBG levels into4 mutually exclusive groups; <7.0 mmol/L, ≥7.0 but <8.0 mmol/L, 8.0 to< 11. 1 mmol/L and ≥11.1 mmol/L. The Statistical Package for Stata, version 9.2 was used for statistical analysis. According to corresponding data analysis of /-test, ANOVA, rank test and exact propability were used respectively. Univariate logistics regression analysis was conducted followed by multivariate logistics regression analysis on significant variables. Results The incidence rate of stress hyperglycemia in patients with AMI without diabetes was 43. 9% (n =47). In non-diabetic patients, the mortality of the group of FBG≥7. 0 mmol/L was significantly higher than the group of FBG < 7. 0 mmol/L, which are 27.66% and 6.67%(P=0.0063)respectively,OR=5.35(95%CI 1.61 - 17.75,P = 0.0061). In-hospital complications for example lung infection, congestive heart failure, serious arrhythmias and acute cerebrovas-cular events were increased significantly in AMI patients with stress hyperglycemia. Multivariate logistic regression analysis for mortality were performed adjusting for risk factors which demonstrated FBG was a independent risk factors of in-hospital death , OR = 1.56(95%CIl.09 -2.23). Conclusions In-hospital mortality and in-hospital complications were significantly increased in patients with AMI without diabetes which developed stress hyperglycemia. Stress hyperglycemia was of great prognostic value for short-outcomes of AMI.

Objective:To explore the utility of psychiatric service of clients having online counseling for anxiety or depression. Methods:The anxiety group was consisted of clients (n=107) who were positive in the Self-rating Anxiety Scale (SAS) online, similarly the depression group was consisted of clients (n=102) with positive results in Self-rating Depression Scale (SDS) online screening. Both groups were investigated with the questionnaires include issues related to the clinical features, diagnostic categories and treatment vs professional advice on clients. Results:In the anxiety group (male 69/female 38), the average age was 28+8, 88(82.2%) with more than 15 years education. In the depression group (male 57 vs. female 45), the average age was 29+8, 81(79.4%) with more than 15 years education. None was illiterate. For the age, sex, education and occupation, there was no significant difference between the two groups. 81(79.4%) clients in the anxiety group and 89(87.2%) clients in the depression group were advised to visit psychiatrists or psychologists. A few were advised to counseling online only and there was no significant difference between the two groups. The main diagnoses were mood disorders, neurosis and psychogenic disorders. Actually, 29(27.1%) in the anxiety group were treated with anxiolitics, 31(30.2%) in the depression group were treated with antidepressants at local clinics. Conclusion:Most of the clients should visit psychiatrists or psychologists, and a few may have their psychological counseling online only. Health education and psychological counseling online may be helpful to improve the rate of diagnosis and treatment of mental disorders in local clinics.

Patients with acute myocardial infarction(AMI) are often with elevated blood glucose level when admitted to hospital,this finding is associated with poor prognosis regardless of a history of diabetes.Though numerous studies have addressed some of the questions in this field,many critically important questions are still poorly understood and under debate.This article summarized current findings in hyperglycemia and its potential link withadverse outcomes in AMI patients,and addressed some of the existing controversies in this field.

Objective To investigate the correlation between the characteristics of intracranial lesions and the level of cognitive function in patients with an initial diagnosis of brain metastases.Methods A retrospective analysis was performed in 51 patients with an initial diagnosis of brain metastases who were admitted to The Second Hospital Affiliated to Suzhou University from January 2015 to April 2016.CT and (or) MRI were used to determine the characteristics of intracranial lesions and the Montreal Cognitive Assessment was used to evaluate the cognitive function of patients.Comparison between groups was made by Mann-Whitney U test.The correlation between ranked data was analyzed by Spearman rank correlation test.Results Of the 51 patients with an initial diagnosis of brain metastases,47(92%) had cognitive impairment,including mild cognitive impairment in 31(61%) and dementia in 16(31%).There was no significant difference in level of cognitive function between the patients with involvement of the left hemisphere alone and those with involvement of the right hemisphere alone (P=0.425).The patients with involvement of both hemispheres had a significantly lower level of cognitive function than those with involvement of the left hemisphere alone (P=0.042).The patients with involvement of three or more brain lobes had a significantly lower level of cognitive function than those with involvement of one or two brain lobes (P=0.015,0.024).The intracranial lesion volume and edema volume had no significant effect on the overall cognitive function of patients (P=0.077,0.178).The patients with>3 intracranial lesions had a significantly lower level of cognitive function than those with 1-3 intracranial lesions (P=0.010).Conclusions More than 90% of patients with an initial diagnosis of brain metastases have cognitive impairment.Cognitive impairment is mainly associated with lesion site,involvement of brain lobes,and number of lesions,but not with lesion volume and edema volume.

Objective To study effect of high ilioinguinal approach in treatment of acetabular fractures involving quadrilateral plate. Methods 28 cases of acetabular fractures were randomly divided into two groups according to admission time. 16 patients in the observation group were given high ilioinguinal approach operation. 12 patients in the control group were treated with traditional ilioinguinal approach op-eration. Operation condition, fracture reduction, the hip function recovery and postoperative complications of the two groups were compared. Results The amount of bleeding, the length of incision, operation time and operation conditions of the two groups had no significant differ-ence (P>0. 05). The satisfactory fracture reduction rate of observation group was higher than the control group (P<0. 05). Hip function score of observation group was significantly higher than that of the control group (P<0. 05). In observation group, the excellent rate of hip joint function was better than that of the control group (P<0. 05). The incidence rate of complications in the observation group and the con-trol group were 12. 50% and 16. 67% respectively, and there was no significant difference between the two groups (P>0. 05). Conclusion High ilioinguinal approach can improve the fracture reduction effect, effectively improve the hip joint function in patients, and it has higher security which is a kind of ideal treatment approach for acetabular fractures involving quadrilateral plate.

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.

Objective: To observe the targeting therapy of the hdsFv-RC-RNase recombinant single chain immunotoxin on the xenograft of the human hepatocellular carcinoma in nude mice and to explore its clinical potentiality. Methods: The prokaryotic expression vector TIG-hdsFv-RC-RNase was transformed into E.coli BL21(DE3)plys to largely express recombinant single chain immunotoxin hdsFv-RC-RNase against hepatocellular carcinoma induced by IPTG. The expressed product was purified via Ni-NTA affinity chromatography under native conditions and mildly refolded. The ELISA was used to analyze its immunological activity of antigen-binding capability. The xenogrft model of the human hepatocellular carcinoma in nude mice was established and the targeting therapy of hdsFv-RC-RNase was evaluated. Results:After induced by IPTG, a new protein band with M_r 41 000 was found in the supernatant of the bacteria and expressed in a soluble form. The expressed product was purified to homogeneity via Ni-NTA affinity chromatography under native conditions. The results of ELISA showed the refolded hdsFv-RC-RNase had the specific antigen-binding capability to the human hepatocellular carcinoma cell, but not to the normal hepatocyte (P