Objective To explore the effect of the procedural nursing management on nursing quality of hospitalized patients in department of rheumatology. Methods About 267 inpatients were divided into control group (n=125) and experiment group (n=142). The control group received routine medication nursing and the experiment patients were treated with procedural nursing management including implementing medication services and analyzing the factors influencing precise medication and the countermeasures . Result The rate of precise medication in the experiment group was significantly higher than that of the control group ( P<0 . 05 ) . Conclusions The procedural nursing management can promote patient's precise medication so as to ensure the therapeutic effect by medication . It does good for the promotion of medication scientizeation and professionalization .

OBJECTIVE:To promote the clinical application and improve the curative effect of serum concentration.METHODS:In a retrospective review,the serum drug concentrations of 487 outpatients and inpatients of our hospital treated with 3 kinds of anti-epileptics included valproic acid,phenytoin and carbamazepine were analyzed.RESULTS:Among 487 samples,there were 248 cases(50.92%) whose serum concentration were in normal range,177 cases (36.34%) in low range and 51 cases(10.47%) in high range.Also,there were 11 cases(2.26%) whose serum concentration could not be monitored.The percentage of patients treated with valproic acid,carbamazepine and phenytoin whose serum concentrations in normal range were 48.18%,74.29% and 10.87%.CONCLUSION:The serum concentration monitoring of Anti-epileptic is the important measure which provide the basis for adopting individualized administration and ensures the clinical effect and safety in the medical care.

Objective The primary culture of synovial fibroblasts is a convenient tool to study the pathology and physiology of synovial tissues .An improved method was constructed in this study by C57BL /6 mice to study the mechanism of rheumatoid ar-thritis(RA) .Methods The synovium around the hip joints were collected .Attention should be paid to eliminate the egg-yolk like yellow oval substance in the middle of the synovium .The synovium was transferred into a 1 .5 mL Eppendorf tube containing 0 .5%type Ⅳ collagenase and cut into 1 mm3 blocks or so .The Eppendorf tube was placed in 37 ℃ Constant temperature orbital shaker incubator for 60 min .After digestion ,the tube was placed on the Vortex for a high-speed oscillation for 1 .5 minutes to guarantee the separation of cells .Results Within about 1 week ,the first passage was performed by the trypsin digestion method .On day 10 , the number of synovial macrophages reached the maximum and then decreased gradually .After the third generation (day 15 to 20) , the synovial macrophages generally disappeared .Vimentin was suitable for the immunofluorescence cytochemical staining for the synovial fibroblasts .The cell purity was indicated as > 95% .The cytometric analysis indicated that purity of Vimentin and CD90 .2-labelled cells was over 95% ;the purity of CD54-labelled cells was 80% approximately .Conclusion It is a simple and effective method for primary culture of synovial fibroblasts in mice .

[ ABSTRACT] AIM: To investigate the seroprevalence of neutralizing antibodies to human adenovirus type 5 (AdHu5) , human adenovirus type 26 (AdHu26) and chimpanzee adenovirus type 68 (AdC68) in the patients with chro-nic hepatitis B ( CHB) and the patients with primary liver cancer ( PLC) , and to provide guidance for developing safe and effective biotherapy vectors against CHB and PLC.METHODS:The blood samples from 196 patients with CHB and 193 patients with PLC were examined to assess the presence of neutralizing antibodies against AdHu5, AdHu26 and AdC68 by adenovirus neutralization assays.RESULTS:The seroprevalence rates of neutralizing antibodies to AdHu5, AdHu26 and AdC68 in the CHB patients were 84.7%, 58.2%and 39.8%, respectively.Among the patients with PLC, the prevalence rates of neutralizing antibodies were as follows:AdHu5, 75.1%;AdHu26, 66.8%;AdC68, 32.1%.CONCLUSION:The prevalence rates and titers of neutralizing antibodies against AdC68 were the lowest among the 3 adenoviruses.There-fore, AdC68 serves as more suitable biological therapy vectors for CHB and PLC than AdHu5 and AdHu26.

Objective To analyze the clinicopathological characteristics and prognosis of different subtypes of breast cancer patients with bone metastasis.Methods For this study, we recruited 300 primary breast cancer patients with bone metastasis treated at the Department of Oncology, the First Affiliated Hospital of Xi`an Jiaotong University, between September 1, 2007 and September 1, 2011.We also retrospectively analyzed their clinical and follow-up data.Results The percentage of Luminal A, Luminal B, human epidermal growth factor receptor-2 (HER-2) overexpression and triple negative subtypes in all the bone metastatic breast cancer patients was 59.0％, 16.0％, 13.7％ and 11.3％, respectively.Age, tumor size and histologic grade significantly differed among the four subtypes (P<0.05).However, there were no significant differences in menopausal status, lymph node metastasis, histological type or lymphovascular invasion among different subtypes (P>0.05).The median survival time of Luminal A breast cancer patients with bone metastasis was 28.6 months, longer than Luminal B (26.9 months), HER-2 overexpression (20.9 months) and triple negative breast cancer patients (12.0 months) with bone metastasis.The overall survival significantly differed among the patients with four subtypes of breast cancer.Conclusion Different subtypes of breast cancer patients with bone metastasis have different clinical characteristics and prognosis.Luminal A breast cancer patients with bone metastasis have better prognosis whereas triple negative subtype has poorer prognosis.

Objective To investigate the prompt value of abnormal vaginal morphology on diagnosing pelvic organ prolapse . Methods Forty eight pelvic organ prolapse female patients diagnosed by pelvic organ prolapse quantification were enrolled in the pelvic organ prolapse group and 51 normal female volunteers were enrolled in the control group in this study. Pelvic MRI T2WI were performed in all cases. The vaginal shape were evaluated according to Delancey Ⅱ level on the transverse images, which were divided into two categories:normal morphology (H-shaped) and abnormal morphology(non H-shaped). The vaginal shape distribution of different prolapse degree(0,Ⅰ,Ⅱ,Ⅲ,Ⅳstage) and types(anterior,middle, posterior pelvic prolapse) were recorded. Chi-square test was used to analyse distribution difference of vaginal shape between the two groups. The ROC curve was used to analyse the diagnostic efficiency of abnormal vaginal morphology for diagnosing pelvic organ prolapse. Results In the control group, there were 40 cases with normal vaginal morphology and 11 cases with abnormal morphology mainly including W-shaped and U-shaped abnormal morphology. In the prolapse group, there were 5 cases with normal vaginal morphology and 43 cases with abnormal morphologymainly including U-shaped (13 cases), W-shaped (26 cases) and O-shaped(4 cases) abnormal morphology. There was significant difference between the two groups(c2=46.137,P<0.01). The area under the curve (AUC) was 0.800. The sensitivity and specificity of abnormal vaginal shape for diagnosing pelvic organ prolapse were 89.6% and 78.4%respectively.The distribution of vaginal morphology in different degrees and types of prolapse were different:vaginal morphology of 0 stage prolapse showed H-typed mainly (40/51, 78.4%), Ⅰ stage prolapse showed W-shaped (16/28 57.1%), Ⅱ,Ⅲ stage prolapse all showed non H-shaped (20/20, 100%), Ⅱstage mainly showed W-shaped (9/14), Ⅲ stage mainly showed O-shaped (3/6). Anterior pelvic organ prolapse were manifested mainly with W-shaped vaginal morphology (4/9) and middle pelvic organ prolapse mainly showed O-shaped vaginal morphology (4/7). Conclusions The abnormal vaginal morphology has the prompt value on diagnosing pelvic organ prolapse.Moreover, the different shape probably indicates the different degrees and types of pelvic organ prolapse.

OBJECTIVETo introduce and evaluate the technical feasibility and anatomical and functional outcomes of one-stage vaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis.

METHODSWe retrospectively reviewed our experiences with 17 patients with Mayer- Rokitansky-Kuster-Hauser syndrome treated with primary surgery from September 2010 to April 2013. All patients underwent vaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis. We describe the details of this technique, observe the time of epithelization and evaluate the long- term anatomical, functional, and sexual outcomes.

RESULTSThe time of epithelization was 13 d (range: 12-15 d). At a mean follow-up of 15 months (range: 12-24 months), the mean postoperative dependence on the vaginal stent was 11.7 ± 1.64 months (range: 9-15 months), the mean depth of the neovagina was (9.0 ± 0.94) cm (range: 7-11 cm), the mean circumference was (12.3 ± 1.36) cm (range: 10.0-14.5 cm) and the mean volume was (105 ± 10) ml (range 85-120 ml). The mean female sexual function index score of the 12 sexually active patients was 29.5 ± 2.6. No spouse reported discomfort during intercourse.

CONCLUSIONSVaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis is an effective and feasible approach for patients with Mayer-Rokitansky-Kuster-Hauser syndrome. The procedure has satisfactory long-term anatomical and functional results. The use of the acellular allogenic dermis is limited by the high price and the potential infection.

46, XX Disorders of Sex Development ; surgery ; Acellular Dermis ; Coitus ; Congenital Abnormalities ; surgery ; Feasibility Studies ; Female ; Humans ; Mouth Mucosa ; transplantation ; Mullerian Ducts ; abnormalities ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Vagina ; abnormalities ; surgery

China ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli O157 ; classification ; genetics ; Genes, Bacterial ; Humans ; Molecular Typing ; Virulence

Objective: To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China. Methods: In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed. Results: Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ²=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ²=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ²=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ²=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ²=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ²=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases). Conclusion A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.

Objective: To investigate the antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of S.paratyphi A strains in Zhengzhou city isolated from sentinel hospitals in 2013-2015. Methods: According to Salmonella molecular typing and K-B drug susceptibility testing method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI2015), we analyzed drug sensitivity and PFGE molecular characteristics of 67 S.paratyphi A strains(11 strains in 2013, 7 strains in 2014, 49 strains in 2015) isolated from blood and stool samples in two sentinel hospitals of fever with rash syndrome surveillance system established in Zhengzhou city in 2013-2015. Results: The results showed 67 strains of S.paratyphi A had different levels of resistance to 13 kinds of antibiotics, 65 strains were multi-drug resistant strains (97.0%), 5 isolates were resistant to 2-3 kinds of antibiotics (7.5%), 41 isolates were resistant to 5-8 kinds of antibiotics (61.2%),11 isolates were resistant to 9-10 kinds of antibiotics(16.4%),8 isolates were resistant to 11-12 kinds of antibiotics(11.9%). 67 strains of S.paratyphi A were divided into 10 molecular patterns(PTYA1-PTYA10) by digestion with XbaⅠ restriction endonuclease and pulsed field gel electrophoresis, each pattern contains 1-48 strains with similarity ranged from 94.31%-100%. PTYA3 contained 48 strains, which was predominant band type; PTYA1, 9 contained 6 strains; PTYA 2, 4, 5, 6, 7, 8, 10 contained 1 strains among them. Conclusion The status of drug resistance of clinical isolates of S.paratyphi A in Zhengzhou city was rather serious, PFGE patterns showed diversity and dominant characteristics. The PFGE patterns of partial strains and its corresponding anti-drug spectrum have certain relevance and cluster relationship.