Objective To explore the application effect of clinical nursing pathway on maintenance hemodialysis patients.Methods Totally 120 patients with maintenance hemodialysis between January 1 and December 31 2009 were randomly assigned to the control group and the observation group with 60 patients in each group.The clinical pathway was established and applied to the observation group.The treatment effect was compared between two groups.Results The incidence of complications and nursing errors declined with the application of clinical nursing pathway,and the doctor's orders compliance and the satisfaction and quality of care were improved significantly.Conelusions The application of clinical nursing pathway in maintenance hemodialysis patients is an effective method for improving overall care quality and the satisfaction degree of the patients with nursing,so as to improve their survival rate.

Objective To analyse the cause for delaying diagnosis of WG and improve the diagnosis level.Methods A retrospective study was done on patients who were admitted to the People's Hospital of Peking University and were diagnosed with WG from 1997 to 2007,by searching the computer system of the hospital for patients with WG,who were misdiagnosed and reported in Chinese Journal of Rheumatology and Clinical Misdiagnosis ﹠ Mistherapy from 2003 to 2007.Results WG included multiple systems and organs ivolvement.The lung,kidney and upper airway were the most commonly involved organs,and ear,eye,external salivary gland and oral cavity were also involved.Most initial symptom and clinical manifestation were not typical manifestation of WG trilogy,which led to misdiagnosis and mistreatment.Anti-neurophil cytoplasmic antibody(ANCN)positive rate was high.The most common pathologic features were necrotizing granulomatous inflammation and vasculitis.Conclusion Clinical manifestation of WG is complicated and it injures multiple system or organs.When the symptoms are atypical,it is easy to lead to misdiagnosis,especially in early stage.We suggest running requisite revision for diagnostic criteria of WG,in order to make early diagnosis and treatment of WG.

Objective To investigate the clinical efficacy of electroacupuncture at Huatuo jiaji points plus acupuncture point injection in treating postherpetic neuralgia.Methods Sixty-two patients with postherpetic neuralgia were randomly allocated to a treatment group of 32 cases and a control group of 30 cases. The treatment group received electroacupuncture at Huatuo jiaji points plus acupuncture point injection and the control group, oral administration of carbamazepine tablets, vitamin B1 and vitamin B12. The pre-treatment and post-treatment clinical symptom score and VAS score were recorded in the two groups and the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 93.8% in the treatment group and 66.7% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in clinical symptom item scores (pain, pruritus, burning sensation and sleep) in the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P<0.05). There was a statistically significant difference in pre-/post-treatment VAS score difference value between the treatment and control groups (P<0.05).Conclusion Electroacupuncture at Huatuo jiaji points plus acupuncture point injection is an effective way to treat postherpetic neuralgia.

Objective To evaluate whether P53 gene mutation was related with the pathogenesis of ovarian malignant epithelial tumors or not.Methods P53 gene mutation in exons 5-8 was detected by polymerase chain reaction product-single strand conformation polymorphism analysis (PCR-SSCP).Results The mutation in benign tumors: 3(10%) cases, but in malignant epithelial tumor:19(38%) cases(P0 05).Conclusions P53 gene mutation in exons 5-8 was probably related with the pathogenesis of ovarian malignant epithelial tumors, but was not related with histological grade.

Objective To study the influence of HBV infection for gastromucous membrane in chronic hepatitis B and cirrhosis and its pathogenesis.Methods The liver biopsy,gastroscope,liver function and HBVM were detected at the same time in 60 patients with chronic hepatitis B and cirrhosis.HBsAg and HBcAg in the tissues of liver and gastromucous membrane were detected by SP immunohistochemistry.Results The damage of gastromucous membrane were found in 56 of 60 patients.Its damage degree was showed as moderate and severe.The other 34 showed mild and moderate damage(P

Ion chromatography(IC)can make up the deficiency of LC or GC for the analysis of ionic drugs because of the unique separation mechanism,so IC is more and more widely applied in the field of drug analysis. In the paper,the application of IC is reviewed in the quality control of chemical drugs.

Objective To discuss the expression and mutation of β-catenin gene in breast carcinoma.Methods 119 breast carcinomas, 72 adenosis of breast tissues and 40 normal breast tissues were studied.Using immunohistochemistry studies to detect the expressions of β-catenin, then analyzing their relationship with the clinicopathological features of breast carcinomas. Gene mutation of β-catenin (exon 3) in 44 cases of breast carcinoma were analyzed by polymerase chain reaction (PCR) and then by direct sequencing.ResultsIn 40 cases of normal breast tissues, epithelial cells showed equally strong membranous of β-catenin protein at the cell-cell boundaries. The abnormal rate of β-catenin in breast carcinomas (78.15 %) was much higher than that of adenosis of breast tissues (44.44 %), the significant correlation was found (P＜0.01). The abnormal expression of β-catenin was associated with lymph node metastasis (P=0.031). Mutation of β-catenin gene was not detected in 44 cases of breast carcinoma, while the abnormal rate of β-catenin in 44 cases of breast carcinoma was 77.30 %. Conclusionβ-catenin abnormal expression could be considered as an useful marker for determining metastasis and prognosis of human breast carcinoma and for guiding treatment. β-catenin abnormal expression is not caused by β-catenin gene mutation, maybe by other mechanisms. It needs further study.

Objective To investigate the imaging diagnostic value of ureter cysts.Methods The intravenous pyelogram(IVP), CT MRI and ultrasonic data of 17 cases of ureter cyst were analysed trtrospectively. Results All patients were correctly diagnosed preoperatively. The application of US and intravenous cystography may aid to improvement of diagnosis.Conclusion The combination of multiimaging modalities was proved to be of great value in diagnosis of ureter cysts.

ObjectiveTo report clinical, pathological and molecular genetic features in a Chinese family with hereditary motor and sensory neuropathy type 6. MethodsThe index case is a 15 years old boy.He developed progressive distal limb weakness at the age of 5.The disease deteriorated slowly,accompanied with contracture of achilles' tendon. At the age of 11 years old he suffered from decrease of visual acuity. At the age of 12, he found the muscular atrophy of both hands without sensory disturbances.Visual evoked potential revealed prolonged latency of bilateral P100. Ophthalmological examination showed bilateral optic atrophy. His mother had the similar symptoms at the age of 7 and reduced visual acuity at the age of 10. Nerve conduction velocity revealed in both pat1ents no compound motor and sensory nerve action potentials in most nerves or slightly reduced nerve conduction velocities with severely reduced amplitudes of the compound motor and sensory nerve action potentials. Sural nerve biopsy was performed on the proband.The sequence of MFN2 gene was analyzed in DNA from the index, his mother and 100 healthy controls.ResultsSural nerve biopsy revealed severe loss of myelinated fibers with few regenerating clusters.Ultrapathological examination showed a few of atypical bulbs of myelinated fibers, occasionally regenerating clusters, mitochondrial swelling and aggregation in a few of axons. A new mutation of W740R mutation in MFN2 gene has been identified in the index case, her mother, but not in 50 healthy controls. Conclusions A novel MFN2 gene mutation result in hereditary motor and sensory neuropathy type 6.Mild visual loss appeares after the lesion of spinal nerves. Demyelination of peripheral nerve appears in the disease.

Objective To investigatethe changes of serum IL-12 level and Th balance of chronic hepatitis B (CHB) patients in the course of lamivudine therapy and the related significance. Methods According to the differ ent responses to lamivudine therapy, patients were divided into three groups: group I ( n = 10), HBeAg positive CHB and complete response group; group Ⅱ (n = 10), HBeAg positive CHB and non-complete response group;group Ⅲ ( n = 5), HBeAg negative CHB group. Sera were collected from patients with chronic hepatitis B before and after lamivudine therapy and healthy blood donors. Then serum IL-12, IFN?, and IL-4 levels were measured by ELISA method. The ratio of IFN?/IL-4 was selected as the marker of Th balance after comparison with that of the normal control. Results Before therapy, serum IL-12 level in chronic hepatitis B patients was lower than that of the healthy blood donors, and Th balance tendency was to Th2 direction. After lamivudine therapy, serum IL-12 level was increased. The highest point of IL-12 was observed in complete response group at the third month after therapy.The tendency of Th balance was to Th 1 direction in complete response group and to Th 2 direction in non-complete response group and HBeAg negative group. Conclusion After lamivudine therapy, the immunity response to HBV of chronic hepatitis B patients can be recovered. The response degree to therapy is associated with the level of serum IL-l2 and Th balance recovery level after lamivudine therapy. Serum IL-12 level may be an appropriable marker to predict the effect of lamivudine therapy in earlier period of the whole course. The recovery of Th balance is the assurance of complete response.