Epistaxis ; diagnosis ; etiology ; Hemophilia B ; complications ; diagnosis ; Humans ; Male ; Young Adult

Antitussive Agents ; poisoning ; Child, Preschool ; Dextromethorphan ; poisoning ; Humans ; Male

Objective To understand the risk of heterotopic pregnancy when intrauterine pregnancy and abdominal pain co-exist. Methods and results We report a patient with heterotopic pregnancy in a naturally occurring pregnancy; she also had high risks for secondary infertility. At gestational week 13 she had hemorrhagic shock due to intrauterine pregnancy complicated with rupture of tubal pregnancy; salpingectomy was performed via open operation. The intrauterine pregnancy was uneventful after operation, and a healthy baby was delivered through cesarean section at 37+2 weeks due to placental previa. Conclusion Heterotopic pregnancy usually occurs in women receiving assisted reproductive technology, but it can also happen in natural conception when there are high risk factors. Satisfactory outcome can be obtained in patients with heterotopic pregnancy, rupture of tubal pregnancy, and hemorrhagic shock, if prompt measures and supporting treatment can be given.

Objective To study the impact of postoperative aerobic exercise on the cardiac function of breast cancer patients during anthracyclines-based chemotherapy. Methods Sixty cases of female breast cancer pa-tients, from June 2014 to December 2015 for anthracyclines-based chemotherapy, were randomly divided into ex-perimental group (n = 30) and control group (n = 30). Four cycles of conventional anthracyclines-based chemotherapy were conducted in control group, while three times of aerobic exercise per week were added in exper-imental group until the end of treatment course apart from conventional treatment. The peak oxygen consumption (VO2max) and maximum heart rate (HRmax) were measured before and after chemotherapy in both groups, ac-companied by ECG monitoring and blood collecting to measure the changes in their N-terminal pro-brain natriuretic peptide (NT-proBNP), serum creatinine (SCr) and kinase isoenzyme (CK-MB). Results No significant differ-ences in various indicators before chemotherapy were reported between two groups (P>0.05). After chemotherapy, VO2 max/kg [(21.9 ± 3.6) vs. (14.5 ± 2.8) mL/(min·kg)], VO2 max [(1 523 ± 186) vs. (911 ± 185) mL/min] and HRmax[(115 ± 15) vs. (129 ± 16) beats/min] in experimental group were significantly improved when com-pared with those in control group; significant differences in hematological levels and ECG changes were also ob-served between two groups. Conclusion Aerobic exercise during chemotherapy can mitigate the cardiotoxicity of anthracyclines to patients, which provides a new idea and therapy to reduce the incidence of clinical cardiovascular events induced by anthracyclines-based chemotherapy.

Glioblastoma(GBM)is one of the most common primary intracranial tumor that has high de-gree of malignancy ,invasive ability and a fatal prognosis .In recent years ,with the development of modern technol-ogy in biomedical sciences ,the understanding on GBM has developed gradually from pathological diagnosis to mo -lecular classifications ,which is based on the molecular characteristics of genetic signatures .Based on gene expres-sion and DNA methylation patterns , primary glioblastoma is divided into four subtypes , including the classical , neural,proneural and mesenchymal .These molecular classifications are closely relevant to the biological charac-teristics of glioblastoma .This review briefly introduces the molecular classifications of primary glioblastoma , but mainly focuses on the changes of the major genetic EGFR ,PTEN and PI3K,CDKN2A in the classical subtype of GBM,and discusses the treatment strategies for primary glioblastoma .

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.

Objective To investigate the molecular epidemiology of CRAB isolated from children in wuhan. Methods Forty non-repetitive strains of CRAB were collected from hospitalized children of emergency department, neonatal medicine, cardiothoracic surgery, bone surgery, respiratory medicine and renal medicine in Wuhan children's hospital during December 2008 and May 2009. MIC values were PFGE; KPC, IMP, GIM, SPM, SIM, OXA-23, VIM genes and integrase gene were amplified by PCR and then sequenced to confirm the genotypes.; Plasmid conjugation experiment was used to study the transfer method of bacterial resistance and southern blot hybridization was used to target the resistance genes. Results Susceptible rates of 40 strains to gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, trimoxazole were 20%, 5%, 93%, 93%, 95%, and 23% respectively. Eleven types of clone were detected by PFGE,including 29 strains of type A clone, 2 strains of type B clone, and 1 strain for each type of C to K clone. Eleven isolates produced both IMP-4 and OXA-23 carbapemase. Twenty-six isolates only possessed OXA-23 carbapemase. Thirty-six strains carried class Ⅰ integron. The results of southern blot hybridization showed that Intl, IMP-4 and OXA-23 type were located on chromosome. Conclusions Type A clone of CRAB is the most common. OXA-23 and IMP-4 type are the major acquired carbapemases, especially the OXA-23 is the most common type. The horizontal transmission of OXA-23 and IMP-4 gene mediated by Int1 and the spread of type A resistant clone is the major way of the spread of carbapenem-resistant Acinetobacter baumannii in the region.

Abscess ; complications ; Adult ; Brain Abscess ; complications ; Female ; Humans ; Meningocele ; complications ; Nasal Cavity ; pathology ; Nose Diseases ; complications

Objective To study the effect of Buzhong Yiqi Decoction serum on cell cycle of A549/DDP cell. Methods A549/DDP cells and splenocytes cells were cultured in vitro and divided randomly into three groups:control group, Buzhong Yiqi Decoction group and splenocyte group. A 549/DDP cells were stimulated by different concentrations of Buzhong Yiqi Decoction serum and spleen cells, the direct killing effect on cells were measured by MTT method, cell apoptosis were detected by lfow cytometric analysis and the apoptotic body were observed by immunolfuorescence method. Results MTT results showed that cell growth were inhibited by Buzhong Yiqi Decoction serum in contrast with control groups, and the effect was same as spleen cells, and both treated groups had similar effects. Marked apoptotic peak and the apoptotic body were seen by lfow cytometric analysis and lfuorescence microscope in both two groups. Conclusion Buzhong Yiqi Decoction could inhibit the proliferation of A549/DDP cells in vitro and induced cell apoptosis, which is the similar as spleen cells.

Objective To observe the clinical efficacy of Jianpi Huatan Decoction plus Zhongwan (RN12) moxibustion on patients of mild to moderate stable chronic obstructive pulmonary disease (COPD) with syndrome of qi deficiency of lung and spleen, and analyze the related influencing factors. Methods With prospective randomized clinical trial, 140 cases of mild to moderate stable COPD were randomized into two groups (70 cases for each group). Treatment group was treated by Jianpi Huatan Decoction plus Zhongwan moxibustion based on western medicine, and control group was only treated by western medicine. Both groups were treated for 12 weeks and followed up for 12 weeks. Scores of clinical symptoms and quality of life questionnaire were examined, and multiple logistic regression analysis was used to find possible impacting factors on the effect. Results Symptoms were significantly alleviated after treatment (P<0.01) in both groups. The clinical effects and quality of life in treatment group were significantly improved than the control group (P<0.01). There were no significant changes in life quality of control group ( P>0.05). Multiple logistic regression analysis showed that different therapies and severity of COPD were the major influencing factors of clinical effect (P<0.05, P<0.01). Conclusion Jianpi Huatan Decoction plus Zhongwan moxibustion had significant therapeutic effect on mild to moderate stable COPD patients with syndrome of qi deficiency of lung and spleen by alleviating symptoms and improving quality of life. Treatment style and severity of COPD are the main influencing factors.