Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; trends ; Philosophy, Medical

Emergency Treatment ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; complications ; therapy ; Myocardial Infarction ; complications ; therapy ; Pancreatitis ; complications ; therapy ; Treatment Outcome

Adolescent ; Constriction, Pathologic ; Female ; Fibromatosis, Aggressive ; complications ; pathology ; Humans ; Pharyngeal Diseases ; etiology ; pathology

Objective To investigate the status quo of nursing lack in level three first-class hospitals of Zhongshan city,and analyze the relevant reasons.Methods A sample of 765 nurses in 4 tertiary general hospitals completed the modified Missed Nursing Care Survey.Results Assessment,planning,intervention and evaluation were reported to be missed by 9.86％～39.04％,12.05％～44.38％,3.29％～46.85％ and 12.19％～22.05％ of the survey respondents respectively.Reasons for missed care were lack of labor resources(85.48％～93.84％),lack of material resources(80.00％～80.96％),low efficiency of the team (78.08％～86.58％),poor work habits (70.95％～83.84％),and improvement of patients’ needs (88.90％～93.01％).Conclusions Lack of care is widespread,and the degree of lack of each link is different.Reasons lead to the lack of care of nursing staff are higher patients’ demands to nursing work,shortage of nursing staff and unplanned surge of patients’ number.

The aim of this study is to investigate the influence of different posts on the fracture mechanics of endodontically-treated teeth with open apex. Forty-eight human maxillary anterior teeth were collected, and the root was transversely sectioned 12 mm under the cementoenamal junction (CEJ). These samples were then randomly divided into two groups, i.e., minor diameter open apex root (group A) and major diameter open apex root (group B), with mineral trioxide aggregate (MTA) placed into the apical 4 mm in the root canals. Subsequently, both groups were respectively further divided into three subgroups as follows: fiber-post (subgroup 1), metal post (subgroup 2) and non-post (subgroup 3) group. Teeth were restored with a composite resin crown and tested by using a universal testing machine at the rate of 1 mm/min cross-head. Values of the maximum fracture resistance and failure patterns were recorded and compared among all subgroups. In addition, the changes of MTA properties were carefully examined via X-ray photography. Our results indicate that (1) In group A, the mean value of fracture resistance for teeth restored with fiber posts were statistically higher than that with either metal post or non-post; (2) In group B, there was no statistically significant difference in the mean value of fracture resistance among three subgroups; (3) No statistical significance in the mean value of fracture resistance was found between group A and group B; (4) The failure modes of most samples (58%) were irreparable; (5) MTA in two teeth developed cracks after loading tests. In conclusion, endodontically-treated teeth restored with fiber posts are more resistant to fracture than those restored with either metal posts or non-post, and most of the fracture modes are catastrophic in nature.

Objective To explore the expression of miR-21 and miR-19a in juvenile idiopathic arthritis (JIA) and the relationship among the key target genes (SOCS3,STAT3) in JAK/STAT pathways.Methods The venous blood from 33 cases of active JIA in Guangzhou Women and Children Medical Center were collected.All cases were divided into two groups:the systemic group (n=20),polyarthritis group (n=13).Twenty subjects were used as the normal control group.Peripheral blood mononuclear cells (PBMCs) were extracted and separated with Ficoll.miRNA was extracted and purified and real-time quantitative polymerase chain reaction (RT-PCR) was used to obtain cDNA.Target genes of miRNA were detected through Targetscan and RNA22.U6 was used for reference of miR-19a,miR-21 and β-actin were used for STAT3,SOCS3,IL-6,TNF-α mRNA.All the expression were detected by fluorescence quantitative PCR among the groups and calculated the result in standardized 2-ΔΔCT value,non-parametric test was used to test the differences.Results The expression of miR-21 were significantly reduced in the case group than the control group (Z=2.11,P=0.036),in which miR-21 was 7(7-8.5) times reduced than the SJIA group,6.49 (6-7) times than the pJIA group,the difference was statistically significant (Z=2.615,P=0.014 9;Z=2.654,P=0.0291).But no significant difference of miR-21 expression could be found between the SJIA and PJIA groups (Z=0.221,P =0.827 1).The expression of miR-19a was significantly reduced in the case group than the control group (Z=2.41,P=0.014),in which miR-19a was 11.3 (10-12.1) times to the SJIA group,12.2 (12-13.5) times to the pJIA group,the difference was statistically significant (Z=2.334,P=0.015 7;Z=2.414,P=0.026 6).But no significant difference could be detected in the miR-21 expression between the SJIA and the PJIA groups (Z=0.538,P=0.596).Software estimated that STAT3,SOCS3,TNF-α were the target genes of miR-21 and miR-19a in the JAK/STAT pathways respectively.Fluorescence quantitative PCR had shown that mRNA expression of STAT3 [6.24(2.81,7.54) and 3.97(1.81,5.75),P=0.001,0.008],TNF-α [3.03(2.07,3.80) and 3.42(2.46,4.68),P=0.002,0.001],IL-6[4.75(3.59,6.32) and 3.52(2.31,7.51),P=0.006,0.036],SOCS3[2.54(1.77,4.00) and 3.57(1.95,3.83),P=0.003,0.001] was higher in the case Group (SJIA group,the PJIA group) than the control group;STAT3 mRNA expression was negatively correlated with the miR-21 (r=-0.585 4,P=0.006 7;r=-0.613 4,P=0.044 7) and there was statistically significant difference.TNF-α,SOCS3 mRNA expression in the case group (SJIA group,PJIA group) was negatively correlated with the miR-19a.TNF-α (r=-0.664 2,P=0.001 4),SOCS3 (r=-0.790 3,P=0.000 1) of the SJIA group,was higher than those of the PJIA group TNF-α (r=-0.626 1,P=0.039 3),SOCS3 (r=-0.8824,P=0.003),the difference was significant.Conclusion The expression of miR-21,miR-19a in PBMC in the JIA patients are lower than the control group.The high expression of the target genes,miR-21,miR-19a of STAT3,SOCS3,TNF-α suggest that these genes might associate with,activating of JAK/STAT pathway.

Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for metastatic bone tumours. Methods Eighty patients with metastatic bone tumour by meta were randomly derided into two groups study group(n=40), and the eantrol group (n=40). The study group received 4 mg zoledronic acid infusion for 15 minutes combined with radiotherapy (DT 30Gy/10f/2w) ,control group was only treated with radiotherapy. The primary effective parameters were pain scores, quality of life, KPS scores and pain relief rates. The vital signs, bi-ochemical and hematological parameters were determined. Results The overall response rates of study group and control group were 97.5% and 72.5% ,respectively(P<0.05). The overall response rate of movement capacity im-provement was 87.5 % in the study group and 65.0% in the control group(P<0.05). There was statistical signifi-cance of QOL and KPS in two groups (P<0.01). An adverse event of mild systemic skeletal pain was recorded after pamidronate infusion and completely reversed after 8 hours. Conclusion Zoledronic acid combined with radiothera-py is effective and safe for treating malignant tumour with mestastatic bone tumours. It is a better way to treat meta-static bone tumors at present.

Surgical resection (usually lobectomy) is considered the treatment option for individuals with stage Ⅰ and Ⅱ non-small cell lung cancer. The surgical treatment of stage Ⅰ and Ⅱ non-small cell lung cancer (NSCLC) continues to evolve in the areas of intraoperative lymph node staging (specifically the issue of lymph node dissection vs sampling), the role of sublobular resections instead of lobectomy for treatment of smaller tumors (especially peripheral carcinoma ≤2 cm in diameter), and the use of video-assisted techniques to perform anatomic lobectomy. Video-assisted thoracic surgery (VATS) lobectomy provides a minimally invasive approach for the management of early-stage lung cancer. Questions about the safety of VATS lobectomy and its adequacy as a cancer operation compared with open thoraeotomy have hindered its universal acceptance among thoracic surgeons. Evidence suggests that VATS lobectomy can be safely performed and is an adequate cancer operation for early-stage NSCLC. Recently, robots have been introduced into surgical procedures in an attempt to facilitate surgical performance. However, adequately powered well-balanced studies comparing VATS with open thoracotomy for lobectomy are lacking in the literature.

Objective To evaluate the safety of myomectomy by extrusion in cesarean section , in comparison with routine cesarean delivery. Methods From January 2008 to December 2010, a total of 128 operations of myomectomy by extrusion in cesarean section were performed (Myoma Group), while another group of 128 cases undergoing caesarean section , which respectively followed every cases of the Myoma Group but had no hysteromyoma , was selected as the control group .The amount and rate of postpartum hemorrhage , the level of postpartum fever , and postoperative hospital stay between the two groups were compared , respectively. Results In the two groups:the amount of postpartum hemorrhage was (233.6 ±58.9) ml vs.(228.5 ±90.9) ml (t=0.530, P=0.597); the rate of postpartum hemorrhage was 0% (0/128) vs.0.8% (1/128) (P=1.000); the decrease of haemoglobin was (6.17 ±2.83) g/L vs.(6.89 ±3.09) g/L (t=-1.944, P=0.053); the decrease of hematocrit was 2.22%± 0.98%vs.2.27%±1.02% (t=-0.400, P=0.690); the rate of postpartum fever was 2.3% (3/128) vs.5.5% (7/128) (χ2 =1.665, P=0.197);the length of postoperative hospital stay was (4.2 ±0.8) d vs.(4.1 ±1.2) d (t=0.706, P=0.481). There were no significant differences between the two groups in the abovementioned parameters . Conclusions The myomectomy by extrusion in cesarean section does not increase the level of postpartum hemorrhage and the rate of postpartum infections .It is a simple, minimally invasive , safe and feasible surgical method , being worthy of clinical application .