Middle Aged ; Humans ; Siblings ; Mutation ; TATA-Binding Protein Associated Factors/genetics*

Objective To investigate the relationship between the expressions of osteopontin (OPN), matrix metalloproteinase 2 (MMP-2) and vascular endothelial growth factor (VEGF) in gastric cancer and the poor prognosis of gastric cancer patients. Methods A total of 35 patients with gastric cancer after radical gastrectomy from January 2014 to March 2015 in Dalian Third People ' s Hospital were retrospectively analyzed. The expressions of OPN, MMP-2 and VEGF in gastric cancer tissues and adjacent normal tissues were detected by immunohistochemical SP staining. The relationship between the expressions of OPN, MMP-2 and VEGF and the poor prognosis of gastric cancer patients was analyzed. Results The positive expression rates of OPN, MMP-2 and VEGF in postoperative pathological tissues of gastric cancer were 80.0％ (28/35), 77.1％(27/31) and 88.6％(31/35), respectively. OPN expression was associated with vascular invasion, lymph node metastasis, degree of differentiation, degree of invasion, and Lauren classification (all P< 0.05). MMP-2 expression was associated with vascular invasion, lymph node metastasis, and degree of invasion (all P<0.05). VEGF expression was associated with vascular invasion, lymph node metastasis, degree of invasion, and Lauren classification (all P< 0.05). OPN, VEGF and MMP-2 had synergistic effects in the invasion and metastasis of gastric cancer, and the expressions of them were positively correlated (all P< 0.05). The sensitivity of combined detection of OPN, VEGF and MMP-2 (87.5％) was higher than the sensitivity of individual detection (68.8％, 62.5％ and 56.3％) (P< 0.05). Conclusions OPN, MMP-2 and VEGF expressions are closely related to the poor prognosis of gastric cancer patients, and have synergistic effects in the invasion and metastasis of gastric cancer. The combined detection of OPN, MMP-2 and VEGF may have a more accurate prediction of the prognosis of gastric cancer.

Objective To evaluate hospital acquired infection control using the risk assessment method of hazard vulnerability analysis (HVA). Methods The HVA risk assessment method was used to screen out two hospital-level priority improvement projects in hospital acquired infection management in 2016, and assess the relative risk of the risk factors,for selective intervention according to the"20% -80% principle". 2015 was set as baseline survey, while the first and second half of 2016 as the outcome evaluation stage. The comparison of the count data was performed using the χ2test. Results Baseline survey of hand hygiene found the compliance rate and high-touch surface cleaning pass rate as 64.4% and 57.0% respectively. The first stage of evaluation found the rate as 69.0% and 73.7% respectively, while in the second stage rate was 72.9% and 82.4% respectively. These differences were statistically significant (P<0.001). Baseline survey found the incidence of hospital acquired infection and surgical site infection as 1.26% and 0.29% respectively, while the figures in the stage of evaluation were 1.07% and 0.22% respectively,figures being statistically significant (P<0.05). Conclusions The HVA risk management proves significant for the prevention and control of hospital acquired infection, as it can identify and assess risk factors of hospital acquired infection,for better risk control.

Objective To evaluate the effect of targeted monitoring and comprehensive intervention measures on reducing the occurrence of catheter-associated urinary tract infection(CAUTI)in patients in non-intensive care unit(Non-ICU).Methods In quarter 4 of 2015,patients with indwelling urinary catheter in clinical departments were conducted a baseline survey(before intervention),risk factors for CAUTI in patients were analyzed,targeted monitoring programmes and comprehensive intervention measures were initiated in 2016(after intervention),incidence of CAUTI before and after intervention was compared.Results After taking intervention measures,hand hygiene compliance rate increased from 78.51%in quarter 4 of 2015 to 92.99%in quarter 3 of 2016 and 90.73%in quarter 4 of 2016(x2=7.342,3.998,respectively,both P<0.05),the correct disposal rate of patients' urinary catheterization system increased from 72.83%in quarter 4 of 2015 to 95.44%in quarter 4 of 2016(x2=30.267,P<0.05).A total of 12 067 patients with indwelling urinary catheter were monitored,incidence of CAUTI dropped from 1.03%(24/23 313)in quarter 4 of 2015(before intervention)to 0.53%(14/26 595)in quarter 4 of 2016(after intervention),difference was statistically significant(x2=4.126,P=0.042).Conclusion Improving the quality of urinary catheterization system in patients with indwelling catheter through targeted monitoring can effectively reduce the incidence of CAUTI in patients in Non-ICU.

Objective To investigate personal identification of mixed seminal stain of two individuals, we combined the detection of genotyping autosomal, Y and X STR and sequencing mtDNA hypervariable Ⅰ (HV Ⅰ ) region. Methods We analyzed autosomal, Y and X STR with commercial kit and separating and sequencing HVⅠfragments of mixed seminal stain from two males by SSCP electrophoresis. Results Four genetic markers of the high amount sample can be obtained when mixed ratio is more than 1:10. When the proportion of two samples is close, the suspect could be excluded or, to some extent, identified by comparing with our results. Conclusion The combined detection of four genetic marker systems can, to some degree, solve the personal identification from mixed seminal stain of two individuals.

Objective To investigate the effect of visual management on the prevention of nosocomial infection for the patients in hospital in the department of gynecology and obstetrics.Methods Three hundred and sixteen in-patients who were treated in the department of obstetrics and gynecology in our hospital from July 2013 to June 2014 were included in the control group. The routine prevention infection management was used in the control group. Three hundred and twenty-five in-patients who were treated in the department of obstetrics and gynecology in our hospital from October 2014 to September 2015 were included in the observation group. The visual management was used to prevent infection in the observation group. Hospital infection,infection site,length of hospital stay and patients' satisfaction were compared between the two groups.Results There were 22 cases of hospital infection in the two groups,including 5 cases in the observation group and 17 cases in the control group. The difference between the two groups was statistically significant (x2=8.532,P<0.01). In the observation group, the infection rate of infection sites of the patients was significantly lower compared with the patients in the control group (P<0.05). In the observation group,the average hospitalization time was (6.2±1.6) d,which was significantly shorter compared with the patients in the control group (8.6±2.1) d (t=3.26, P=0.001). The total satisfaction in the observation group was 100.0%,which was significantly different from that in the control group (89.6%) (x2=7.814,P<0.05).Conclusions The implementation of visual management to prevent infection in the patients of the department of gynecology and obstetrics can reduce the infection rate of patients,shorten their hospitalization time and improve patients'satisfaction of the intervention.

Objective To evaluate the feasibility and efficacy of endoscopic push?radial dissection (EPRD)for benign esophageal stricture(BES). Methods Clinical data of 24 patients diagnosed as having BES who received EPRD were analyzed. The procedure and efficacy were evaluated. Results All 24 patients underwent EPRD successfully with mean operation time being 32 min(15?45 min).The mean esophageal stric?ture incision length was 3?? 2 cm (1?? 0?8?? 0 cm).No severe complications related to EPRD occurred, or trans?ferred for surgery. Patients were followed up for 1?5 months (mean 2?? 8 months). Dysphagia was relieved signif?icantly during the follow?up in 23 patients where endoscopy could go through smoothly. But dysphagia re?oc?curred in one patient 2 weeks after the operation, who underwent a second EPRD and stent implantation, then dysphagia was relieved. Conclusion EPRD is safe, feasible and effective for benign esophageal stricture.

Objective To compare the value of transvaginal ultrasound and MRI in diagnosis of the first-trimester cesarean scar pregnancy (CSP).Methods The transvaginal ultrasound and MRI data of 28 patients who were initially diagnosed as CSP were analyzed. Regarding the surgery and postoperative pathology as a gold standard,the differences between transvaginal ultrasound and MRI were compared in the sensitivity,specificity,diagnostic coincidence rate and the ability in showing the internal structure of gestational sac and its relationship with the surrounding tissue.Results 22 CSP patients were confirmed by surgical pathology in a total of 28 patients,while 20 CSP patients using transvaginal ultrasound and 1 9 using MRI were correctly diagnosed respectively,and the sensitivity,specificity and diagnostic coincidence rate were 90.9%,50.0%,82.1% vs 86.4%,83.3%,85.7%,respectively,exhibiting no statistical difference in the coincidence rates between two methods (χ2 =0.132,P=0.72 ).The pregnant bursa in 20 patients was found by pathology in 22 CSP patients,and 19 pregnant bursa with transvaginal ultrasound and 17 with MRI were confirmed respectively,exhibiting no statistical difference between two methods (χ2 =1.11,P =0.29).The yolk sac in 12 patients,embryos in 8,original heart tube in 5 and local scar pregnancy sac infiltration in 3 were found with transvaginal ultrasound,meanwhile those in 2,2,0 and 9 respectively were also found with MRI,exhibiting significant differences between the two methods (χ2 =13.8,P =0.000;χ2 =7.7,P =0.006;χ2 =7.2,P =0.007;χ2 =7.1,P=0.008).The pregnancy capsule hemorrhage in 7 patients and hemorrhage in uterine cavity in 9 were found with transvaginal ultrasound, meanwhile those in 14 and 1 5 were found with MRI,exhibiting significant differences (χ2 =6.6,P =0.01;χ2 =5.0,P =0.026). Conclusion The coincidence rate in diagnosis of CSP using transvaginal ultrasound or MRI is higher.Transvaginal ultrasound is superior to MRI in showing the yolk sac,embryos and original heart tube,while MRI is better than transvaginal ultrasound in showing the hemorrhage of uterine cavity or gestational sac and the relationship between pregnant bursa and the surrounding tissue.Combination of the two methods shows more value in early diagnosis of CSP.

Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.

ObjectiveTo discuss the effects of adsorption(AP) combined with continuous venovenous hemofiltration(CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.ResultsThere was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).ConclusionAP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH.