Objective:To explore the effective diagnosis method and the clinical effect of laparoscopic technique for atypical CE1 hepatic cystic echinococcosis.Methods:The clinical data of 17 patients with atypical liver cystic echinococcosis from June 2018 to June 2019 in the People's Hospital of Xinjiang Uygur Autonomous Region were analyzed retrospectively, including 11 males and 6 females, (46.0±21.6) years old, all patients with a history of exposure in animal husbandry area. Preoperative hydatid immunity test, abdominal ultrasound and abdominal CT examination were completed, and laparoscopic surgery was performed. Postoperative follow-up was conducted by outpatient review and telephone, and the follow-up period was up to June 2020. The diagnosis, operation and recurrence of hydatid disease by different examination methods were analyzed.Results:Preoperative serum immunological examination of 17 patients showed that 11 were positive and 6 were negative for hepatic echinococcosis. The results of abdominal CT showed that 17 cases were hepatic cyst. Conventional color doppler ultrasound showed that 14 patients were hepatic cyst, 3 patients showed cystic space occupying, and cystic hydatidosis was not excluded; 9 patients observed double track sign or local thickening of cystic wall at the top of hepatic cystic lesions after replacement of high-frequency probe, which was diagnosed as hepatic cystic echinococcosis(CE1) , 8 patients as hepatic cyst. All 17 patients underwent laparoscopic operation, during which they were definitely diagnosed as hepatic cystic echinococcosis (CE1). During the operation, there was no conversion to laparotomy. The operation time was (125.0±54.5) min, the intraoperative blood loss was (150.0±84.5) ml without blood transfusion, and the postoperative hospital stay was (6.5±2.5) d. There were no serious complications or deaths in the perioperative period, 2 cases had microbile leakage, and recovered by themselves 5-10 days after the operation; the patients were followed up for 6-12 months, no loss of follow-up, no recurrence of liver and abdominal hydatid.Conclusions:In the process of diagnosis and treatment of liver single cystic lesions, we should pay attention to the differential diagnosis of atypical CE1 hepatic cystic echinococcosis and simple liver cyst. The effective differential rate of abdominal spiral CT, hydatid immune experiment and abdominal ultrasound is low, which is easy to be misdiagnosed and missed. The high frequency probe of abdominal ultrasound can effectively find atypical CE1 hepatic cystic echinococcosis. Laparoscopic technique is not only an effective diagnosis method but also a treatment method. It is necessary to choose a reasonable operation method according to the patient's hydatidosis. Laparoscopic operation is safe and feasible in the treatment of hepatic cystic echinococcosis.

Objective:To investigate the role of clinical pharmacists in the anti-infective treatment of one patient with complexity urinary tract infection with septic shock induced by cellulitis. Methods:Clinical pharmacists participated in one case of complexity uri-nary tract infection with septic shock induced by cellulitis, and according to the clinical curative effect and the patient' s condition change, clinical pharmacists adjusted the medication nine times and provided individualized pharmaceutical care and service in the whole process. Results:Physician accepted the suggestions of clinical pharmacists, the infection was controlled after the 38-day treat-ment, and then the patient was discharged from the hospital. Conclusion:Clinical pharmacists should participate in the clinical treat-ment, provide whole process of pharmaceutical care for severe patients and assist physician in drug treatment decisions to promote safe, effective and economical drug use.

Animals ; Arrestins ; metabolism ; Hypoxia ; metabolism ; Male ; Prefrontal Cortex ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; metabolism ; beta-Arrestin 1 ; beta-Arrestins

We investigated the antibiotic‐resistant genes and genetic diversity of Pseudomonas aeruginosa from patients in hospital ,the smear samples from hospital and clinic environment ,and from medical staff’ hands respectively in 2011‐2012 in Nanshan District of Shenzhen .Polymerase chain reaction were used to detect the 20 kinds of antibiotic‐resistant genes (TEM , VEB,CARB,OXA,SHV,PER,GES,GTX,SPM,GIM,IMP,VIM,DHA,oprD,Aac(6′)‐Ⅰ ,Aac(6′)‐Ⅱ ,Aac (3′)‐Ⅰ ,A ac(2″)‐Ⅰ ,qacE1‐sull and int‐Ⅰ) .Multilocus sequencing typing was used to analyze the clonal complexes .The 11 kinds resistant genes TEM ,SHV ,IMP ,DHA ,Aac(6′)‐Ⅰ ,Aac(6′)‐Ⅱ ,Aac(3′)‐Ⅰ ,Aac(2″)‐Ⅰ ,qacE1‐sull ,int‐Ⅰand oprD were detected ,for the positive rates respectively ,and which were 8 .1% ,6 .4% ,4 .8% ,9 .7% ,4 .8% ,14 .5% ,9 .7% , 56 .5% ,8 .1% ,and 8 .1% ;the loss rate of oprD gene was 61 .2% .The 19 antibiotic resistance gene profiles existed in 52 Pseudomonas aeruginosa strains .Multilocus sequencing typing found 39 sequence types and 5 clonal complexes in 62 Pseudo‐monas aeruginosa strains ,CC244 and ST856 were dominant .There were some differences of antibiotic resistance gene profiles between different samples ,the Pseudomonas aeruginosa strains from patients carried multiple resistant genes .In our research , the Pseudomonas aeruginosa had the genetic diversity and the dominant clonal complexes existed .

Objective The research aimed at evaluating whether non-invasive endolymphatic MR imaging could be used in aged patients(≥60 years)suffering from Meniere's disease.Methods Under guidance of nasal endoscopy,a diluted gadopentetate dimeglumine injection was administrated through eustachian tube into mid-ear cavity in four patients (≥60 years old) suffered from Meniere's disease.3D-FLAIR MRI scan was performed one day after the administration.Results The administration succeeded through eustachian tube into mid-ear cavity in those four patients.A rise of fluid level on tympanic membrane while administrating a diluted gadopentetated meglumine injection was observed.Imaging of inner ear endolymphatic spaces were visible in vestibule and cochlea in imaging of patient 1.As to patient 2,in cochlea the scala tympani of the first and second turns were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.In images of patient 3,the scala tympani of the three turns in cochlea were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.For Patient 4,in cochlea the scala tympani of the first turn were enhanced while scala vestibule weren't,and the second turn was partially enhanced;and endolymphatic space of vestibule could be distinguished from perilymphatic space.Conclusions This technique could be adopted in investigation of Meniere's disease in elderly patients.MR imaging of endolymphatic spaces in vestibule and cochlea can be visualized,which may partially provide data for diagnosis of Meniere's disease.

Esophageal Diseases ; complications ; Esophagus ; pathology ; Female ; Foreign Bodies ; complications ; Hematoma ; complications ; Humans ; Middle Aged ; Pharyngeal Diseases ; complications ; Pharynx ; pathology

To explore one-step method for the preparation of Ganoderma lucidum multicomponent microemulsion, according to the dissolution characteristics of triterpenes and polysaccharides in Ganoderma lucidum, formulation of the microemulsion was optimized. The optimal blank microemulsion was used as a solvent to sonicate the Ganoderma lucidum powder to prepare the multicomponent microemulsion, besides, its physicochemical properties were compared with the microemulsion made by conventional method. The results showed that the multicomponent microemulsion was characterized as (43.32 +/- 6.82) nm in size, 0.173 +/- 0.025 in polydispersity index (PDI) and -(3.98 +/- 0.82) mV in zeta potential. The contents of Ganoderma lucidum triterpenes and polysaccharides were (5.95 +/- 0.32) and (7.58 +/- 0.44) mg x mL(-1), respectively. Sonicating Ganoderma lucidum powder by blank microemulsion could prepare the multicomponent microemulsion. Compared with the conventional method, this method is simple and low cost, which is suitable for industrial production.

Objective To explore innovative teaching mode of cultivating the communicated ability of undergraduate nursing students based on standardized patients and then evaluate its effect.Methods To select 2 classes of sophomore randomly,four-year nursing undergraduate enrolling in 2012,was divided into the experimental group and the control group.Experimental group used standardized patients as carrier of skills and control group took dummy patient as carrier of skills lasting for one academic year.Assessed by others and self-assessment was used to evaluate the communicated ability of nursing students at end of the course respectively.Results There was statistical significance between two groups in the score of communicated ability,94.39±8.18 vs 87.04±6.56,t=4.61,P ＜ 0.01.Teachers for clinical communication ability of nursing students and standardized patients for skills and clinical communication ability of nursing students were more satisfied with experimental group,the satisfactory rate in the experimental group was 63％(26/41),37％(15/41) and 56％(23/41) respectively,which were higher than those in the control group [24％(11/45),22％(10/45) and 22％(10/45)],P＜ 0.01.Conclusion It is helpful for increasing communicated ability of nursing students taking standardized patients as practice objects which could be as a reference for building teaching system of nursing students in communication.

The field of gene therapy has been increasingly studied in the last four decades, and its clinical application has become a reality in the last 15 years. Traditional Chinese medicine (TCM), an important component of complementary and alternative medicine, has evolved over thousands of years with its own unique system of theories, diagnostics and therapies. TCM is well-known for its various roles in preventing and treating infectious and chronic diseases, and its usage in other modern clinical practice. However, whether TCM can be applied alongside gene therapy is a topic that has not been systematically examined. Here we provide an overview of TCM theories in relation to gene therapy. We believe that TCM theories are congruent with some principles of gene therapy. TCM-derived drugs may also act as gene therapy vehicles, therapeutic genes, synergistic therapeutic treatments, and as co-administrated drugs to reduce side effects. We also discuss in this review some possible approaches to combine TCM and gene therapy.

Objective To investigate the clinical and pathological characteristics of IgA nephropathy (IgAN) with macrohematuria (MH).Method 1512 consecutive patients with biopsyproven IgAN diagnosed from January 2006 to December 2011 were enrolled,and divided into MH group and control group respectively,according to whether there existed episodes of MH before renal biopsy.The clinical and pathological characteristics were compared between two groups.Patients in MH group were then divided into three groups according to the interval from the last episode of MH to renal biopsy to clarify the concomitant clinicopathological changes associated with occurrence of MH.Results The rate of MH in history was 22.1％.MH group patients had significantly lower serum creatinine,slighter proteinuria,lower prevalence of hypertension and heavier microhematuria than control group (all P ＜ 0.001).The prebiopsy durations were similar in two groups (P=0.627).In MH group,chronic pathological indicators,including global/segmental sclerosis,tubule atrophy/interstitial fibrosis were all slighter (all P＜ 0.001),whereas activity indicators,including necrosis lesions,crescents and mesangial proliferation were all more severe compared with control group (all P ＜ 0.05).Those who underwent renal biopsy within 30 days of the last episode of MH had more severe proteinuria and microhematuria,higher prevalence of necrosis lesions,more severe crescents formation,and endothelial proliferation (all P ＜ 0.05).Conclusions IgAN patients with MH in history have relatively milder clinical and chronic pathological manifestations,however more active pathological changes especially in those who suffer episode of MH recently.