Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.

Objective To investigate the effects of different analgesia protocols on immune function in patients undergoing surgery for ovarian neoplasms after neoadjuvant chemotherapy.Methods Forty ovarian neoplasms patients ageing from 31 to 62 years undergoing neoadjuvant chemotherapy were randomly divided into 2groups:epidural analgesia group (group E,n =20) and intravenous analgesia group (group Ⅰ,n =20).All patients underwent surgery under total intravenous general anesthesia.Patients in group E were given 2 mg morphine in epidural space at half an hour before abdomen was closed,then epidural analgesia pump was installed,with ropivacaine composite morphine in the pump.Analgesia time was 48 h.Patients in group Ⅰ were given sufentanil 0.1 μg/kg intravenously at half an hour before abdomen was closed,then analgesia pump was installed,with sufentanil compound flurbiprofen ester in the pump.Analgesia time was 48 h.The cervical venous blood samples were obtained from the patients at 30 min before surgery(T0),immediately(T1),12 h(T2),24 h(T3) and 48 h (T4) after the end of operation for determination of the expression of CD3 +,CD4 +,CD8 + on T cells and natural killer cell.Visual analogue scales (VAS)and adverse reaction at T2-4 were recorded.Results No statistical difference was found between group E and group Ⅰ in VAS and adverse reaction.Compared with T0,CD3 +,CD4 + T-lymphocytes,CD4 +/CD8 +,and NK cell decreased.Compared with group E,CD8 + increased at T1-2in both groups and at T3-4 in group Ⅰ.CD3 +,CD4+ T-lymphocytes,CD4+/CD8 + and NK cell decreased while CD8 + increased at T2-4 in group Ⅰ.Conclusion Epidural analgesia may be better to promote the immunologic function of ovarian neoplasms patients undergoing surgery after neoadjuvant chemotherapy.

Arrhythmogenic Right Ventricular Dysplasia ; Humans

Reduced graphene oxide-BiPO4 ( RGO-BiPO4 ) nanocomposite was synthesized successfully via a one-pot solvothermal method using graphene oxide and bismuth nitrate as precursors and glycerin as solvent at 200℃ for 1 h. The morphology and structure of as-prepared nanocomposite were characterized by SEM, TEM, XRD, XPS, SERS and UV-Visible spectrum. The photocatalytic activity of the nanocomposite was evaluated by the photodegradation of Rhodamine B ( RhB) dye under UV irradiation and it was found that RGO-BiPO4 nanocomposite possessed higher photocatalytic activity than that of pure BiPO4 . RhB could be decomposed 87. 5% within 2 h. Under the same conditions, only 45. 7% of the RhB dye could be decomposed by BiPO4 . The enhancement of photocatalytic activity could be attributed to the effective charge separation due to the electron-accepting and transporting properties of graphene.

Obiective To study the characteristics and the correlation factors of ADR induced by Ginkgo Leaf Extract and Dipyridamole Injection on the purpose of providing reference for clinical rational administration.Methods All ADR cases that induced by Ginkgo Leaf Extract and Dipyridamole Injection reported between January 2006 and August 2009 were retrieved and statistically analyzed.Results Of all 24 ADR patients induced by Ginkgo Leaf Extract and Dipyridamole Injection,the female patients were more than the male,and the senile patients had highest incidence 41.67%.Most ADR events happened within 30min(70.83%).ADR mainly manifested as adverse reactions of skin and appendants(33.33%),followed by central nervous system adverse reaction.Conclusion Great importance should be attached to ADR induced by Ginkgo Leaf Extract and Dipyridamole Injection.Medication monitoring should be enhanced to avoid occurrence of ADR clinically.

Objective To study the influence of unilateral and bilateral amplification on the effect of hearing aid evaluation .Methods Using the subjective method that International Outcome Inventory for Hearing Aids (IOI-HA) and objective method that medium acoustic intensity (65 dB SPL) word recognition score(WRS) to evaluate the effect of unilateral and bilateral hearing aid fitting of middle -aged severe sensorneural hearing loss .Results Hearing aid were used for severe sensorneural hearing loss and the improvement of monosyllables and sentences in quiet and noise test of unilateral were 35 .73% ,43 .15% ,43 .23% ;the improvement of monosyllables and sentences in quiet and noise test of bilateral were 37 .90% ,51 .33% ,54 .86% .The WRS of bilateral was higher than unilater-al .The score of IOI-HA was 15~37 ,meaning patients with severe sensorneural hearing loss were satisfied with hearing aid ,and there was no statistical significance between unilateral and bilateral fitting .Conclusion The bilat-eral hearing aid fitting was better than unilateral .Binaural hearing loss are recommended to fit bilaleral hearing aids .

Objective To explore whether lymphovascular invasion can be used as a prognostic indicator in patients with bladder cancer underwent radical cystectomy.Methods The series included clinical data of 459 patients who had underwent radical cystectomy for bladder cancer between January 2006 and December 2012 in our hospital.Among all the patients,391 were male while 68 were female.Pathological grade G1 was diagnosed in 47,G2 in 104 and G3 in 308.Amount of pathological stage T1 or Tis or Ta or T0 was 167,T2 127,T3 89 and T4 76.Of all the patients,92 had lymph node metastasis.Follow-up time was between 13 and 99 months.The presence or absence of lymphovascular invasion was determined by HE staining in the radical cystectomy specimen.The x2 test was used to detect the association between lymphovascular invasion and several clinicopathological features,the Kaplan-Meier method was used to compare recurrence-free survival according to findings of lymphovascular invasion in the surgical specimen,and the multivariate Cox proportional-hazards regression model was used to assess the prognostic significance of some factors.Results Lymphovascular invasion was detected in 128 (28％) specimens.Among them,44 (34％) had tumor recurrence.Lymphovascular invasion was significantly associated with gender,tumor grade,pathological stage,lymph node metastasis and disease recurrence.Recurrence-free survival in patients without lymphovascular invasion was significantly higher than that in those with lymphovascular invasion (P＜ 0.05).Cox proportional hazards model showed that age,pathological stage and lymph node metastasis were independent predictors for disease recurrence.Conclusion In patients with bladder cancer underwent radical cystectomy,lymphovascular invasion may have a significant association with some prognostic parameters,but it can not be used as an independent predictor of disease recurrence.

OBJECTIVE To investigate the factors related to sharp injuries of medical staff and explore the standardized occupational safety management model. METHODS According to the recent 4-year registration of 66 cases of medical staff suffered from exposure to sources of blood-transmitted diseases because of sharp injury,a retrospective investigation was taken and the relevant factors were analyzed. RESULTS Operating room and transfusion room had a high incidence of sharp injury,36.4% and 9.1%,respectively. It occurred frequently in treatment of the morning hours (45.5%). As lack of occupational safety prevention and awareness of the standardized preventive measures,there was a high incidence in lower stage clinical medical staff and interns (60.6%). CONCLUSIONS It is necessary to pay attention to the occupational safety standardized management of sharp injuries for medical staff in order to promote medical professional safety.

Objective To investigate the effects of siRNA targeting decoy receptor 3 on the cell proliferation of ovarian carcinoma cell CAOV3. Methods We constructed siRNA targeting decoy receptor 3,which was transfected into ovarian carcinoma cells CAOV3 , and observed the effects of DcR3 siRNA on the cell proliferation of CAOV3 cell by MTT experiment. The experiment contained 3 groups, including the normal control group (CAOV3 cell was not transfected), the negative control group (CAOV3 cell was transfected with blank vector) and the experimental group (CAOV3 cell was transfected with DcR3 siRNA). The expression levels of DcR3 mRNA were detected by Real-time PCR. Results DcR3 siRNA recognized and degraded DcR3 mRNA in CAOV3 cells of the experimental group. DcR3 mRNA of the experimental group was significantly decreased. The proliferation of CAOV3 cell was significantly decreased by DcR3 siRNA comparing with the normal control group and negative control group (P < 0.01). Conclusion DcR3 siRNA can inhibit the proliferation of ovarian cancer cell line CAOV3 by recognized and degraded DcR3 mRNA.

Objective To investigate the risk factors for bacterial pneumonia and the predictive value of early serum procalcitonin (PCT) level for bacterial pneumonia and sepsis classification in patients with acute stroke. Methods The patients with acute stroke in neurological intensive care unit were enroled retrospectively and divided into either a bacterial pneumonia group or a non-infection group according to whether they had bacterial pneumonia or not. The former was redivided into a non-severe sepsis subgroup and a severe sepsis subgroup according to the sepsis classification. The demographics, baseline clinical data, and PCT level (the bacterial pneumonia group was the PCT level when infection occurred, the non-infection group was the PCT level within 24 h of admission) were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for bacterial pneumonia. Receiver operator characteristic (ROC) curve was used to analyze the predictive value of serum PCT level for bacterial pneumonia and sepsis
classification. Results A total of 164 patients with acute stroke were enroled in the study, including 114 in the bacterial pneumonia group (66 in the non-severe sepsis subgroup and 48 in the severe sepsis subgroup) and 50 in the non-infection group. There were significant differences in age, fasting blood glucose level, Glasgow coma scale (GCS) score, and PCT level between the bacterial pneumonia group and the non-infection group (P < 0. 05 ). Multivariate logistic regression analysis showed that fasting blood glucose level ≥7 mmol/L (odds ratio [ OR] 8. 488, 95% confidence interval [ CI] 2. 739 - 26. 300; P < 0. 01), GCS score ≤8 (OR 11. 361, 95% CI 2. 175 - 59. 352; P < 0. 01), and PCT level ≥0. 050 ng/ml (OR 16. 715, CI 5. 075 - 55. 049; P < 0. 01) were the independent risk factors for bacterial pneumonia. In the bacterial pneumonia group, the PCT level (median; interquartile range) in the severe sepsis subgroup was significantly higher than that in the non-severe sepsis subgroup (0. 835 [ 0. 164 - 1. 715 ] ng/ml vs. 0. 114 [0. 073 - 0. 275 ] ng/ml; Z = 4. 818, P < 0. 01 ). ROC curve analysis showed that PCT ≥0. 070 ng/ml could better predict the occurrence of bacterial pneumonia in patients with acute stroke, with sensitivity of 84. 2% , specificity of 74. 0% and the area under the ROC curve of 0. 865 (CI 0. 806 - 0. 924, P < 0. 01); PCT 0. 669 ng/mlcould better predict the occurrence of severe sepsis in acute stroke patients with bacterial pneumonia, with sensitivity of 56. 3% , specificity of 92. 4% and the area under the ROC curve of 0. 765 (CI 0. 672 - 0. 858; P < 0. 01). Conclusions The early PCT level ≥0. 050 ng/ml was an independent risk factor for occurring bacterial pneumonia in patients with acute stroke, its level had certaln predictive value for bacterial pneumonia and the severity of infection.