Objective Toinvestigatetheincidenceofchronicrenalobstructiveexternalappendageinvolvementandtheresultsof MSCTdetection.Methods MSCTdataof120patientswithchronicurinarytractobstructionwereretrospectivelyanalyzed.Results Among120patients,75caseswerefoundwiththeextrarenalappendageinjury(62.5%).Theinjuryoftheextrarenalappendageincluded thickeningofrenalcapsule(8.00%),effusionofrenalsubcapsular(14.67%),thickeningofbridgingseptaoftheperinephricspace (100.00%),lamellarshadowoffatlayerintheperirenalspace(36.00%),thickeningofrenalfascia(96.00%),pararenalspaceeffusion (88.00%),thickeningperitoneal(76.00%),pseudocyst(1.33%),lamellarshadowoffatlayerinextraperitoneal(22.67%)andnapes(6.67%), increasedintraperitonealfatdensity(32.00%)andperitonealeffusion(4.00%).Conclusion MSCTcanclearlydemonstrateextentand rangeoftheperinephricspaceandpararenalspaceinvolvementinchronicurinarytractobstruction.CTscanplayanimportantrolein chronicurinarytractobstruction.

Objective To explore MSCT findings of pulmonary tuberculoma.Methods MSCT data of 62 patients with pulmonary tuberculoma confirmed by clinical and pathological results were analyzed retrospectively.Results Of the 62 patients,64 lesions were detected with single in 60 cases and multiple in 2 cases.The MSCT signs showed as follows:circumscribed round,oval,egg-like or irregular nodules or masses,size ranging from 2-3 cm,cavity in 31 lesions,calcification in 25 lesions,pleural indentation sign in 45 lesions and pleural tail sign in 1 2 lesions.Conclusion The MSCT features of pulmonary tuberculoma are relatively specific such as the multiple patch calcifications within mass,calcification of the whole mass and semilunar cavity on the lateral side of the hilum.The MSCT is a valuable examination for the accurate diagnosis of pulmonary tuberculoma.

Objective:To analyze the dosage distribution and the frequency of each dosage of high-risk tablets in the hospitalized patients in a children's hospital,and study whether the existing specifications of high-risk tablets meet the pediatrics clinical needs. Methods:All the prescriptions including high risk tablets were analyzed from 2014 to 2016 in Shanghai children's medical center. The frequency of every dosage of every drug was analyzed,and the current specifications were judged according to the frequency. New specifications were proposed when the existing specifications did not match the clinical needs. The new frequency of the proposed speci-fications was re-accounted for all the three-year prescriptions in order to evaluate whether the proposed new specifications met the clini-cal needs. Results:Among the five kinds of high-risk oral tablets,methotrexate tablets and vitamin A acid tablets were in accordance with the actual clinical requirements. Mercaptopurine tablets should add two specifications including 12.5 mg and 17 mg,and warfarin sodium tablets should add one specification(1.25 mg). Hydroxyurea tablets(250 mg) and warfarin sodium tablets(1 mg) were rec-ommended used in the children's hospital. Conclusion:The existing specifications of high-risk oral tablets can't fully meet the clini-cal needs,therefore,specifications still needs to be adjusted.

Objective To investigate the association of residual renal function with intradialysis dialysis hypotension among maintenance hemodialysis patients. Methods Fifty-six patients who had underwent maintenance hemodialysis from March 2014 to November 2015 were enrolled according to researching protocol in this study. Data of baseline and clinical parameter of every hemodialysis session were collected. The patients were divided into two groups by 24 h urine output:urine group (24 h urine output≥100 ml, 22 patients)and no urine group (24 h urine output<100 ml, 34 patients). The clinical data were compared between two groups. Results In the 12 weeks’ treatment, 965 times hemodiafiltration were performed in 56 patients, and the rate of intradialysis hypotension was 24.04%(232/965). The rate of intradialysis hypotension in urine group was 19.28%(80/415), in no urine group was 27.64%(152/550), and there was significant difference (P=0.000). The levels of interdialytic weight gain, ultrafiltration volume, ultrafiltration percentage , pre-dialysis systolic and diastolic blood pressure in urine group were significantly lower than those in no urine group (P<0.01). The levels of pre-dialysis weight, intradialysis systolic blood pressure variability, intradialysis diastolic blood pressure variability, heart rate variability, hemoglobin, serum albumin in two groups had no significant differences (P>0.05). Pearson correlation analysis showed that residual glomerular filtration rate (rGFR) had negative correlation with interdialytic weight gain (r =- 0.257, P = 0.001). Kaplan-Meier analysis showed that with the increase of dialysis time, the rate of intradialysis hypotension increased. The comulative rate of intradialysis hypotension in no urine group was higher than that in urine group (log-rank = 14.67, P =0.000). Conclusions Residual renal function is associated with intradialysis hypotension, and it is important for clinician to consider a residual renal function protection schedule for maintenance hemodialysis patients.

Objective To explore MSCT appearances of lung lacerating injury.Methods The MSCT findings of lung lacerating injury in 31 patients were analyzed retrospective.Results The lung lacerating injury of the 31 cases with 67 lesions in total was found,18 of whom were located on the back side of lung near the pleura,11 of whom had solitary lesion and 20 of whom had multiple ones. The MSCT findings included lung cavity in 9 eases,liquid airbag cavity in 1 7 and lung hematoma in 5 .The pulmonary contusion with different degrees was found in all 3 1 cases.Dynamic observation showed the cavities and hematoma could be transformed into each other.Conclusion MSCT is the best method for diagnosis and observation of lung lacerating injury and helpful for the guide of clinical treatment.

Objective To prepare an occupation well-being scale for nurses, and test its reliability and validity. Methods After literature review and semi-structured interviews, the item pool of the occupation well-being scale for nurses was created based on theory of structure of the subjective well-being. After group discussion, and evaluation by the specialists, a pilot scale was obtained. A total of 350 clinical nurses were selected by using stratified sampling method, and their occupation well-being were surveyed by the scale. The data were used to assess the reliability and validity of the scale. Results The occupation well-being scale for nurses had 3 dimensions, including 8 exploring factors. The values of Cronbach Alpha and the split half reliability coefficient of the total scale, endogenous exogenous satisfaction, satisfaction of nurses occupation happiness were all larger than 0.9, which meaned the internal consistency was good. In the emotion dimension, the value of Cronbach Alpha and the split half reliability coefficient were less than 0.7, which meant the internal consistency was not so good. The reliability coefficient of repeated measurement of the whole scale and each dimension were greater than 0.7, suggesting the external consistency of the scale was good. The content validity index of 3 dimensions were all larger than 0.9,and the cumulative ex-planatory variables were all larger than 55%. Conclusion The occupation well-being scale for nurses proposed in this study has good reliability and validity, and can be used to evaluate the occupation well-being of the nurses.

Objective To investigate the sleep status, quality of life, activities of daily living and the serum levels of interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) in insomnia patients after meridian-collateral stroke treated by the new family rehabilitation program, a combined therapy including traditional family rehabilitalion, acupoint massage and ear point application. Methods A total of 80 cases of insomnia patients after meridian-collateral stroke were enrolled. Subjects were evenly divided into treatment group ( treated with new family rehabilitation program) and control group ( treated with traditional hospital health education and family rehabilitation). Clinical effects of the two groups were evaluated with the Pittsburgh Sleep Quality Index (PSQI), the brief version of WHO Quality of Life Assessment (WHOQOL-BREF) and activities of daily living ( ADL) . The serum levels of IL-1β and TNF-α were monitored before and after therapy and measured by enzyme-linked immunosorbent assay ( ELISA). Results ( 1) After treatment for 28 days, the scores of total PSQI, sleep time, sleep efficiency and sleep disorder incidence in the treatment group were significantly lower than those in the control group ( P<0.01) . ( 2) The scores of physiological, psychological, social relation, environmental dimensions of WHOQOL-BREF in the treatment group were significantly higher than those in the control group ( P<0.01) . ( 3) ADL scores were significantly higher in the treatment group than those in the control group (P<0.01) . (4) Serum levels of IL-1βand TNF-αwere increased in the treatment group as compared with those in the control group (P<0.01). Conclusion Compared with the traditional hospital health education, the new family rehabilitation program can effectively improve the quality of sleep, quality of life, as well as the activities of daily living. And the mechanism may be associated with the up-regulation of the serum levels of IL-1βand TNF-α, which are relevant to the sleep status.

Objective To explore the incidence of post-transplant diabetes mellitus (PTDM) by means of fasting plasma glucose (FPG) and other associated risk factors in patients surviving for more than 1 year after renal transplantation.Methods A total of 428 non-diabetic patients,who underwent kidney transplantation from 1 January,1993 to 31 December,2008,were followed up in order to ascertain the prevalence of PTDM after transplantation and other associated risk factors by means of FPG.Results Of the 428 patients,87 developed PTDM (20.3％) within a mean follow-up of (5.65 ± 3.68) years after renal transplantation.The onset of PTDM occurred in 57 patients (65.5％ of total PTDM) primarily within the first year after transplantation.Univariate analysis showed that older age,body mass index (BMI),smoking history,family history of diabetes mellitus,deceased donor transplantation,hepatitis C virus infection,cytomegalovirus infection,FPG before transplantation as well as 1 week after transplantation,total cholesterol and triglyceride before transplantation,switching from cyclosporine to tacrolimus(FK506),and peak plasma concentration of cyclosporine in the first 6 and 12 months were associated with the onset of PTDM.The prevalence of PTDM was markedly elevated in the group who has cyclosporine converted to FK506 (P＜0.05),but not in the group with cyclosporine converted to rapamycin.By multivariate analysis,FPG before transplantation,age,BMI,and deceased donor transplantation were independently associated with the onset of PTDM.Conclusions There is high incidence of PTDM in patients following renal transplantation; and early diagnosis,treatment as well as prevention are mandatory.

OBJECTIVETo study the effects of Chaiqiyigan Granula (CG) and Taxol on the growth of hepatocellular carcinoma (HCC) xenografts and expression of Bax, p53 and VEGF in nude mice.

METHODSWhole-body fluorescence imaging was used to visualize the growth of HCC in nude mice bearing hepG2/EGFP cell xenograft. Immunohistochemistry was used to determine the content of Bax, p53 and vascular endothelial growth factor (VEGF) in the tumor tissues.

RESULTSCompared with normal saline, Taxol alone and in combination with CG significantly inhibited the growth of HCC xenografts in the nude mice. The combined treatment with CG and Taxol produced a stronger inhibitory effect on the tumor growth than Taxol alone in the third and fourth weeks. The volume and weight of the xenografts were decreased in the combined treatment group compared with those in saline treatment group. CG combined with Taxol increased the expression of Bax and reduced the expression of p53 and VEGF in the tumor xenografts.

CONCLUSIONCG can enhance the inhibitory effects of Taxol on the growth of HCC xenografts, and this effect is related to the up-regulation of Bax and down-regulation of p53 and VEGF expression in the tumor.

Animals ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Mice ; Mice, Nude ; Optical Imaging ; Paclitaxel ; pharmacology ; Tumor Suppressor Protein p53 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays ; bcl-2-Associated X Protein ; metabolism