The paper covered the selection of clinical trial diseases in the clinical pathway experiment in the hospital in the recent two years.It also introduced such management measures as making clinical pathway texts,the rate of cases into clinical pathways,emphasis of variation management,and enhanced clinical pathway data analysis.A comparison between the groups before and after clinical pathway management,found that the clinical pathway can reduce the average days of stay and total patient costs by 3.4 days and 1519 yuan respectively.Both patients and hospitals benefit from clinical pathways.The paper also advocates continuous and dynamic management at various stages of clinical pathway management.

Objective To study on postpartum obsessive compulsive disorder at home and abroad,and to provide new idea of diagnosis,evaluation and treatment on postpartum obsessive compulsive disorder.Method A search using Medline,Embase,EBSCO,Cochrane Library,Web of Science (ISI),Pubmed databases and Google Scholar was carried out using the key words:obsessive compulsive disorder (and derivatives),perinatal,pregnancy,postnatal,postpartum,mothers (and derivatives),anxiety disorders and subtypes. These articles and their references were reviewed.Results Twenty-seven papers were incorporated,but no Chinese paper.The life prevalence of postpartum OCD was 2.3％-11.0％.The most common obsessions were aggressive,contamination and miscellaneous,and compulsion for washing/cleaning and checking.Cognitive behavioural therapy and SSRIs have been suggested as a fist-line treatment of postpartum OCD.Conclusion OCD is more prevalent in the postpartum period.The evidence that OCD in the postpartum period presents a distinctive clinical picture with specific symptomatology and course is more compelling.Collaborative,international,prospective studies that take into account the methodological and definitional issues raised in this review are necessary to provide clarification.

Neoadjuvant chemotherapy is widely used in the therapy of locally advanced breast cancer.In the recent studies,the expressions of ER,PR and C-erbB-2 in tumor may change in different scheme preand post-neoadjuvant chemotherapies for breast cancer.It is obviously changed in the neoadjuvant chemotherapy scheme of anthracyclines and paclitaxel/docetaxel,but hardly changed in anthracycline-based neoadjuvant chemotherapy scheme.

Proteolytic cleavage is one of the post-translational modifications and plays important roles in many biological processes, such as apoptosis and tumor cell metastasis. The identification of the cleavage events can improve our understanding of their biological functions in these processes. Although proteomic approaches using N-terminal labeling have resulted in the discovery of many proteolytic cleavages, this strategy has its own inherent drawbacks. Labeling of protein C-termini is an alternative approach. Here, we optimized the labeling procedure in the profiling protein C-termini by enzymatic labeling (ProC-TEL) and improved the labeling efficiency for the positive isolation of protein C-terminal peptides and mass spectrometric identification. We applied this approach to a complex protein mixture from Escherichia coli and identified many C-terminal peptides and internal cleaved peptides from more than 120 proteins. From the identified cleavages, we found several previously known internal proteolytic cleavage sites and many novel ones which may play roles in regulating normal biological processes. This work provides a potential new way, complementary to the N-terminomics, for the identification of proteolytic cleavages in complex biological systems.
Cathepsin A ; chemistry ; Protein C ; chemistry ; Protein Processing, Post-Translational ; Proteolysis ; Proteomics

Objective-To-explore-the-feasibility-and-safety-of-endoscopic-total-thyroidectomy-via-chest-wall-approach-.-Methods-Endoscopic-total-thyroidectomy-via-chest-wall-approach-was-performed-in-20-patients-with-nodular-goiter-from-January-2008-to-December-2012.Subcutaneous-operative-space-was-created-through-an-unilateral-areola-incision-,-through-which-laparoscope-and-surgical-instruments-were-introduced-.The-neck-suture-suspension-technique-was-used-to-reveal-the-thyroid-gland-.By-using-an-ultrasonic-scalpel-,-the-thyroid-was-separated-and-removed-completely-.-Results-All-the-operations-were-successfully-completed-without-conversions-to-open-surgery-.The-operation-time-was-90-180-min-(mean,-120-min).The-blood-loss-was-15-40-ml-(mean,-20-ml).The-postoperative-hospital-stay-ranged-from-4-to-7-days-(mean,-5.8-days).There-was-1-case-of-temporary-hoarseness.No-severe-hemorrhage-,-wound-infection-,-or-subcutaneous-effusion-was-found-.-Conclusion-Endoscopic-total-thyroidectomy-via-chest-wall-approach-is-a-safe-and-feasible-procedure-.

10.3969/j.issn.1000-3606.2013.06.024

Objective To investigate the protective effect of sevoflurane on acute intracranial hemorrhage craniotomy patients. Methods 60 acute intracranial hemorrhage craniotomy surgery patients were randomly divid?ed into control and experimental group of 30 patients under general anesthesia to have craniotomy. The patients in control group was operated by propofol and remifentanil as a inhalation anesthesia ,while patients in experimental group received sevoflurane ,propofol and remifentanil as a mixed anesthesia. Then intracranial pressure ,serum C?reactive protein(CRP),serum S?100β,NSE,IL?6 and TNF?α levels of different time points were deternmined. Results Serum CRP in experimental group were significantly decreased than the control group(P<0.05)1 d af?ter operation. T0~T3 levels of serum S?100β,NSE,IL?6 and TNF?α in two groups were both increased(P <0.05),and the experimental group was significantly lower than the control group(P < 0.05). The intracranial pressure of control group was significantly higher than the experimental group(P < 0.05). Conclusion Sevoflu?rane has a brain protective role in inhibiting acute inflammation in intracranial hemorrhage craniotomy patients.

BACKGROUND: Neurasthenia is commonly believed attributing to the complex influence of psychological, social and biological factors.OBJECTIVE: To probe the correlation of neurasthenia with personality,life events and the positive rate of serum Epstein-Barr (EB) virus.DESIGN: Case-controlled observation and prospective paired analysis.SETTING: Mental Health Institute of Second Xiangya Hospital Affiliated to Central South University.PARTICIPANTS: From May to October 2000, patients with neurasthenia,selected from the Clinical Ward of Mental Health Institute of Second Xiangya Hospital Affiliated to Central South University for medical treatment,19 males and 11 females, with mean age of (27±8), the course of disease ranged from 0.5 to 20 years with the average of 4.0 years, enrolled in this study. According to 1:1 paired principle, 30 matched volenteers, their relatives, or students of Xiangya Hospital were randomly selected as controls.Two groups were matched in age, sex and education, patients with psychological and physical disease were excluded. All participants were given written informed consent.METHODS: The level of serum EB virus IgG and IgM of two groups were determined by using ELISA methods. Blood samples were colleted before and after treatment in experimental group, while blood samples were only collected once in control group. Patients in experimental group were given routine medication and integrative psychotherapy according to their state of illness, and Eysenck personality questionnaire (EPQ) were filled in before and after treatment (including four dimensionalities: neuroticism, psychoticism, extroversion/introvision and lie, amongst which higher scores for extroversion/introvision dimensionality represented extroversion and lower dimensionality represented introvision; higher scores of neuroticism dimensionality suggested anxiety and worry. Higher scores for psychoticism suggested solitude and inadaptability to the outer environment), life events scale (including the total score for life events, positive events value and negative events value), and symptom checklist 90 (SCL-90) (consists of 10 factors scored of 0-4, representing non-symptom to severer symptom) were used to assess the clinical symptom. EPQ and SCL-90 were adopted on patients at four months after treatment for self-comparison. EPQ and life events scale were taken on healthy controls, the scores compared with that of experimental group before treatment.for EPQ, the total scores for SCL-90 and positive rate of EB virus in patients with neurasthenia before and after treatment.RESULTS: Totally 27 patients were followed up at 4 months after treatment, and 3 cases lost due to long distance from hospital, thereby 27 cases in experimental group and 30 cases in control group were remained in the roticism in neurasthenia group was significantly higher than that of control group (57.59±10.79, 40.58±8.68, t=6.536, P ＜ 0.01), scores of extroversion/introvision were obviously lower than that of control group (46.31 ±10.79, 53.50±11.28, t=3.203, P ＜ 0.01). In neurasthenic group, scores for neuroticism was obviously decreased after treatment in contrast to before events scale: The total scores and negative scores in neurasthenia group was significantly higher than that of control group (19.73±17.25, 18.93 tal scores for SCL-90: The total scores for SCL-90 was obviously declined after treatment comparing to that of before treatment in neurasthenia of EB virus IgG and IgM: The positive rate in neurasthenia group was significantly higher than that of control group (76.67% vs 26.67% );and positive rate of serum EB virus were proved to be two important pathogenic factors for neurasthenic patients.CONCLUSION: Patients with neurasthenia possess susceptible personality, such as neuroticism and introvision, and commonly experienced negative life events before illness. Moreover the positive rate of EB virus in neurasthenic patients is higher, which might be associated with the higher glucocorticoidinduced EB virus activation under stress state.

BACKGROUND: Small conductance,Ca2+-activated potassium(SK)channel,presents in various cell types and plays a crucial role in action potential profile.However,coupling and modulation of calcium and associated molecules to SK2 channel remains unclear.OBJECTIVE: To construct the recombinants of pGBAT7 and target fragments of SK2 gene,so as to observe the coupling and regulation of SK2 channel gene to calcium and other molecules.METHODS: Three pairs of primers of the target fragments of SK2 gene were designed and synthesized based on the full-length sequences of SK2.After being identified,they were individually sub-cloned into the yeast expressive plasmid pGBKT7 to construct pGBKT7-SK2 vectors.The recombinant pGBKT7-SK2 vectors were transformed into yeast AH109 by electroporation,and their activation was tested.The recombinants were extracted from yeast AH109 and verified by electrophoresis and sequencing.RESULTS AND CONCLUSION: The target fragments of SK2 gene by PCR were 411,546 and 729 bp,respectively.Three sub-clones of pGBKT7-SK2 were successfully constructed.Electrophoresis and sequencing showed that the constructed sub-clones of pGBKT7-SK2 met the expected requirements.The recombinant pGBKT7-SK2 vectors transformed into the yeast could be activated.The successful construction of the sub-clones of SK2 gene provides an important material basis for further study in the SK2 channel and function-associated molecules.

Objective To evaluate the reliability of colony PCR in identifying the recombinant clones selected from phage antibody libraries. Methods The digested pComb3 vector and Lc fragments, Lc library plasmid, and Fd fragments were ligated successively. The ligation product was transformed into Escherichia Coli strain XL 1-blue bacilli by electroporation and thus murine Fab phage antibody library was constructed.The transformed recombinant clones selected randomly from libraries were identified simultaneously by colony PCR, plasmid PCR and restriction enzyme digestion. The identification consistency was analyzed. The interference was excluded by control PCR using the relevant constituents as template. Results The educed library content of Lc library was 1.175?10 6 CFU and the content of Fab antibody library was 1.02?10 6 CFU. Different recombinant percentages were obtained through three different identification methods (the Lc positive recombinant percentages by colony PCR, plasmid PCR and enzyme digestion were 100%, 78% and 78%, respectively; the Fd positive recombinant percentages by three methods were 90%, 66% and 66%, respectively; the dual positive recombinant (Fd and Lc insert simultaneously) percentages by three methods were 90%, 50% and 50%, respectively). A high frequency of false-positives appeared in colony PCR identification. Nonspecific amplification of control PCR was presumably induced by some intracellular components in XL 1-blue bacilli. Conclusion The identification of the recombinant clones selected from phage antibody libraries by colony PCR remains ambiguous. So it is our assertion that the traditional identification methods such as plasmid PCR or enzyme digestion are more accurate and will less false positive results.