目的 了解医院感染情况，对医院感染控制工作进行评价，为医院感染控制措施提供依据，提高医务人员的感染控制意识。 方法 采用横断面调查的方法，于2012年8月21日进行医院感染现患率调查，将调查结果进行分类、统计、分析。 结果 应查住院患者1 383例，实查1 378例，实查率99.64%，现患率3.41%。医院感染下呼吸道感染占53.19%，泌尿道感染占25.53%，手术部位感染占4.26%，调查当日抗菌药物使用率20.90%。 结论 通过医院感染现患率调查，可快捷地获得全院医院感染的情况，为医院感染防控工作提供依据。
Objective To summarize the research progress of microRNA （miRNA） as a tumor marker in peripheral blood. Methods The domestic and international published literatures about circulating miRNA as a tumor marker in recent years were reviewed. Results The miRNA expression has universality，stability and specificity，and it is related to the occurrence and development of viarous diseases. Conclusion Circulating miRNA shows a broad application prospect in clinical diagnosis， treatment， and prognosis of tumor and other diseases.
Objective To explore the feasibility and clinical effect of management of children with epilepsy based on WeChat platform. Methods The WeChat platform for management of children epilepsy was designed according to the idea of the management of chronic diseases. The objective and control groups were investigated by the case-control study. Eighty children with epilepsy who took part in the platform were served as the experimental group. At the same time, 80 children with epilepsy who did not take part in the platform were served as the control group. The questionnaire of basic conditions and users’ perceived acceptance and usage of the platform designed by ourselves were used to collect related information. Results Sixty parents of children with epilepsy continuously used the platform and among them 48 parents (80.0%) had high satisfaction degree of the platform. The factors which affected the satisfaction degree of the platform among basic conditions included whether the users were busy, the comprehensive degree of knowledge about epilepsy before they took part in the study and the degree of taking medicine on time(P<0.05).There were no differences in satisfaction degree among different children sex, residence, parents’ sex, education level, approaches and willingness of knowledge acquisition(P>0.05). Follow-up of 60 children with epilepsy who had been in the platform for 6 months showed total effective rate was 96.7%, while the total effective rate of the control group was 81.4%. Conclusions Management of children with epilepsy based on WeChat platform is feasible and well accepted. Not only does it contribute to standard long-term management of children epilepsy and health education, but also it improves the efficiency of clinical treatment. It is a new way of the management of children with epilepsy.
【摘要】 目的 观察慢性粒细胞性白血病（chronic myelogenous leukemia， CML）急变（blast crisis，BC）患者罕见染色体异常的临床及实验室特点。 方法 2010年2月1例患者因咳嗽和高热来我院就诊，采用常规方法检查患者骨髓细胞，应用R显带技术和荧光原位杂交技术分析骨髓细胞核型。 结果 患者具有CML-BC的典型临床及实验室特点，同时核型出现不典型t（1；9；22）合并亚二倍体罕见核型异常，临床表现病情进展快，对伊马替尼疗效差，生存期短。 结论 慢性粒细胞性白血病患者在急变期出现伴不典型Ph染色体的亚二倍体复杂核型为高危核型，此类患者可能存在对伊马替尼的耐药，如能取得血液学缓解应尽早接受异基因骨髓造血干细胞移植，争取获得长期疗效。【Abstract】 Objective To report a case of chronic myelogenous leukemia (CML) blastic transformation into acute myelogenous leukemia with rare atypical hypodiploid t(1;9;22) complex chromosome abnormalities, and to analyze its clinical and laboratory characteristics. Methods A 47-year-old man was referred to our hospital due to cough and high fever in February 2010. We collected and analyzed the patient’s clinical materials, and performed chromosomal karyotype analysis with R-banding and fluorescence in situ hybridization (FISH). Results The patient demonstrated typical clinical and laboratory characteristics of blastic crisis of chronic myelogenous leukemia (CML-BC) and displayed rare atypical hypodiploid t(1;9;22) complex chromosome abnormalities. Meanwhile, the disease was rapidly progressive, with poor response to imatinib and had short overall survival. Conclusions CML-BC patients with hypodiploidy complex chromosome abnormalities are in high risk. They may show drug-resistance to imatinib. Thus, for this type of patients, once the hematological remission is achieved, allogeneic stem cell transplant should be performed as soon as possible to get better opportunity for long-term survival.
ObjectiveTo explore the effectiveness of dynamic hip screw (DHS) and intralesional curettage via Watson-Jones approach in treatment of benign bone lesions of the proximal femur.MethodsBetween March 2012 and December 2016, 20 patients (21 lesions) with benign bone tumors or tumor like conditions of proximal femurs were treated with DHS and intralesional curettage via Watson-Jones approach. Their average age was 27.8 years (range, 11-51 years), including 13 males and 7 females. The pathological diagnosis were fibrous dysplasia in 11 cases, simple bone cyst in 2 cases, aneurysmal bone cyst in 2 cases, benign fibrous histocytoma in 2 cases, giant cell tumor in 2 cases, and chondroblastoma in 1 case, including 3 pathological fractures. According to the Enneking staging system, 18 patients were in stage S1, 3 patients with pathological fractures in stage S2. There was no varus deformity or valgus deformity. The operation time, intraoperative blood loss, and time of full weight-bearing were recorded. X-ray film and CT were used to observe the bone graft fusion and location of DHS. Complications were recorded. Visual analogue scale (VAS) and Musculoskeletal Tumor Society (MSTS) scoring were used to evaluate function of lower limbs.ResultsThe average operation time was 177.1 minutes (range, 110-265 minutes). The average intraoperative blood loss was 828.6 mL (range, 200-2 300 mL). There was superficial incision infection in 1 case, deep incision infection in 1 case, and hip discomfort in 1 case, respectively. All patients were followed up 6-63 months (mean, 27.4 months). The time of full weight-bearing was 2 days in 2 patients with giant cell tumor and 2 to 13 weeks with an average of 7.2 weeks in the other patients. At last follow-up, VAS and MSTS were 0.19±0.51 and 29.62±0.97 respectively, showing significant differences when compared with the values before operation (3.52±2.62 and 23.71±8.77) (t=5.565, P=0.000; t=–3.020, P=0.007 ). X-ray film showed the all bone grafts fusion with mean time of 8.2 months (range, 5-12 months). There was no pathological fracture of the femur, local tumor recurrence, chronic hip pain, dislocation, or femoral head necrosis during follow-up.ConclusionThe treatment of benign bone lesion of the proximal femur using DHS and intralesional curettage via Watson-Jones approach is a safe and effective method.
Objective To explore the effects of mechanical stimulation on the expression of autoantigens in myoblasts. Methods According to different processing methods, C2C12 cells were divided into the experimental group and control group; the experimental group was divided into 4 subgroups: 2-, 4-, and 6-day and 1-day stretch groups. In 2-, 4-, and 6-day stretch groups, mechanical loading was added on the C2C12 cells at a stretching frequency of 0.25 Hz and cellular deformation amplitude of 10%, 2 hours a day for 2, 4, and 6 days respectively by Flexercell 5000 strain unit, and at a stretching frequency of 1 Hz and cellular deformation amplitude of 15% for 1 hour in 1-day stretch group. In the control group, the cells were routinely cultured for 1, 2, 4, and 6 days (1-, 2-, 4-, and 6-day control). The cells were observed by inverted phase contrast microscope. The cell proliferation was detected by flow cytometry; the expressions of autoantigens were detected by Western blot method, including the Ku/the catalytic subunit of DNA-dependent protein kinase (DNA-PKcs), U1-70 (A part of ATP-dependent DNA helicase II), histidyl tRNA synthetase (HRS), and Mi-2 (reconfigurable components deacetylase complexes of NuRD). Results The exfoliated cells were found in 1-day stretch group, but no exfoliated cell was seen in the control group for 1-day culture. The cells proliferated more obviously in 2-day stretch group than in the control group for 2-day culture; cell differentiation was found in 4-day stretch group, and cell fusion in 6-day stretch group, which were similar to those in the control group for 4- and 6-day culture. After single stretching, cell apoptosis was found in 1-day stretch group, showing no significant difference in the relative DNA proliferation index (DPI) when compared with DPI of control group for 1-day culture (t=0.346, P=0.747). After cyclic stretching, DPIs of 2- and 4- day stretch groups were significantly increased when compared with those of the control group for 2- and 4-day culture (P lt; 0.05), but no significant difference was found between control group for 6-day culture and 6-day stretch group (t=1.191, P=0.303). Compared with the control group for 2-day culture, the relative protein expression of autoantigens (DNA-Pkcs, Mi-2, HRS, and U1-70) in 2-day stretch group decreased significantly (P lt; 0.05), but no significant difference was found between control group for 4-day culture and 4-day stretch group (P gt; 0.05). The relative protein expressions of autoantigens in 4-day stretch group significantly increased when compared with those of 2-day stretch group (P lt; 0.05), but the relative protein expressions of autoantigens in the control group for 4-day culture significantly decreased when compared with those of the control group for 2-day culture (P lt; 0.05). Conclusion Short-term mechanical stimulation can inhibit the expressions of autoantigens in myoblasts, but with the time prolonging, cell differentiation and fusion and adaptation to mechanical stimulation would result in diminished inhibitory effect.
Objective To explore the effects of mechanical stretch with variant frequencies on the alignment and differentiation of the multilayer myotubes cultured in vitro, and to select the optimized cultural condition of regenerative skeletal muscle tissue with stress loading cultured in vitro. Methods C2C12 myoblasts cultured in vitro in the groove casts of Sylgard 184 were induced into the multilayer myotubes. Meanwhile the myoblasts were treated with various mechanical stretch withcells tensile instrument, at the amplitude of 10% and the frequency of 0 (group A), 0.25 (group B), 0.50 (group C), and 1.00 Hz (group D) for 1 hour, 3 times a day. The myotubes morphology was observed by inverted phase contrast microscope at 5, 7, and 10 days after continuous mechanical stretch. And the expressions of mRNA for myogenic differentiation antigen (MyoD), Myogenin, Desmin, and myosin heavy chain (MyHC) were detected by RT-PCR and real-time fluorescent quantitative PCR (QRT-PCR), respectively. Results The mechanical stretch could promote the al igned fusion and increase the number of myotubes. Indeed the multilayer myotubes arranged more closely in group B at 7 days. At the same group, as the time went on, the mRNA expressions of MyoD gradually decl ined in each group. There were significant differences in mRNA expressions of MyoD between 5 days and 7, 10 days (P lt; 0.05). The mRNA expressions of Myogenin, Desmin, and MyHC were highest at 7 days. There were significant differences between different time points (P lt; 0.05), except the mRNA expression of Desmin of group B between 7 and 10 days (P gt; 0.05). At the same time, with the increase of frequency, the highest mRNA expressions of MyoD, Myogenin, Desmin, and MyHC were in group B. There were significant differences at the same time between group B and the other groups (P lt; 0.05), except mRNA expression of Desmin at 5 days between groups B and C, and mRNA expression of MyHC at 10 days between groups A and B (P gt; 0.05). Conclusion Low frequency (0.25 Hz) and suitable time (7 days) periodic mechanical stretch is beneficial to the differentiation of the multilayer myotubes cultured in the groove casts of Sylgard 184, but as the stretch time goes on the aging of myotubes will be accelerated.
【摘要】 目的 探讨阿托伐他汀强化降脂治疗和左旋氨氯地平联用对高血压患者血压的影响。 方法 选择2009年1月-2010年11月住院及门诊原发性高血压合并高脂血症患者196例，均给予左旋氨氯地平和阿托伐他汀治疗8周后，复查血脂，从其中选择血脂正常者120例，随机分为对照组（单用左旋氨氯地平组）和治疗组（继续左旋氨氯地平联用阿托伐他汀），继续治疗20周后的血压情况。 结果 两组治疗20周后，治疗组收缩压和舒张压均较对照组下降明显，组间差异有统计学意义（Plt;0.01），治疗组优于对照组。 结论 高血压合并高脂血症患者，使用左旋氨氯地平降压和阿托伐他汀降脂治疗时，在血脂降至正常后，继续同时左旋氨氯地平降压和阿托伐他汀强化降脂治疗，降压效果优于单用左旋氨氯地平。【Abstract】 Objective To investigate the effects of levamlodipine combined with atorvastatin on blood pressure in patients with primary hypertension. Methods Between January 2009 and November 2010, 196 patients with hypertension and hyperlipidemia in the outpatient and inpatient departments of our hospital were given levamlodipine and atorvastatin for 8 weeks, after which 120 patients with normal blood lipid were chosen and randomly divided into the control group (treated only by levamlodipine) and the treatment group (treated by levamlodipine combined with atorvastatin). After 20 weeks of the treatment, we observed their blood pressure. Results After twenty weeks of treatment, the diastolic and systolic pressure was significantly lower in the treatment group than that in the control group (Plt;0.01). Conclusion For patients with hypertension and hyperlipidemia who have undergone the treatment by levamlodipine and atorvastatin, after their blood lipid level decreases to normal, the continuous enhanced treatment by the two drugs has a better efficacy compared with the therapy of single levamlodipine in decreasing the blood lipid.
ObjectiveTo investigate the mechanism of magnesium sulfate in protecting rabbit cartilage by initiating autophagy.MethodsTwenty-four adult female New Zealand rabbits were used to prepare post-traumatic osteoarthritis (PTOA) models by anterior cruciate ligament transection. Then, the PTOA models were randomly divided into PTOA group, distilled water group, and magnesium sulfate group, with 8 rabbits in each group. Immediately after operation, the distilled water group and the magnesium sulfate group were injected with 0.5 mL distilled water and 20 mmol/L magnesium sulfate solution in the joint cavity 3 times a week for 4 weeks, respectively. The PTOA group was not treated. The general condition of the animals was observed after operation. After 4 weeks, the expressions of tumor necrosis factor α (TNF-α) and collagen typeⅡ in the joint fluid and the expression of collagen type Ⅱ in venous blood were detected by ELISA assay. The protein expressions of transient receptor potential channel vanilloid 5 (TRPV5) and microtubule associated protein 1 light chain 3 (LC3; LC3-Ⅱ/LC3-Ⅰ) in femoral cartilage were detected by Western blot. The mRNA expressions of interleukin 1β (IL-1β), TNF-α, matrix metalloproteinases 3 (MMP-3) in synovial tissue and collagen type Ⅱ, Aggrecan (AGN), SOX9 in cartilage tissue were detected by real-time fluorescence quantitative PCR. Cartilage tissue sections were stained with HE staining, Masson staining, and Alcian blue staining and scored according to the modified histological osteoarthritis (OA) score.ResultsAll animals survived until the experiment was completed. Compared with the other two groups, the expression of TNF-α in joint effusion and collagen type Ⅱ in joint effusion and venous blood were decreased in magnesium sulfate group; the protein expression of TRPV5 decreased, and the ratio of LC3-Ⅱ/LC3-Ⅰ increased significantly; the mRNA expressions of IL-1β, TNF-α, and MMP-3 in synovial tissue were decreased, and the mRNA expressions of collagen type Ⅱ, AGN, and SOX9 in cartilage tissue were increased; OA scores also decreased significantly. All differences were statistically significant (P<0.05). There was no significant difference in the above indicators between the PTOA group and the distilled water group (P>0.05).ConclusionIntra-articular injection of magnesium sulfate can reduce intra-articular inflammation, reduce the loss of collagen type Ⅱ and AGN, and is beneficial to cartilage regeneration in rabbits. The mechanism may be related to the initiation of chondroautophagy by inhibiting the calcium channel TRPV5.
To enhance the quality and transparency of oncology real-world evidence studies, the European Society for Medical Oncology (ESMO) has developed the first specific reporting guidelines for oncology RWE studies in peer-reviewed journals ‘the ESMO Guidance for Reporting Oncology Real-World Evidence (GROW)’. To facilitate readers understanding and application of these reporting standards, this article introduces and interprets the development process and main content of the ESMO-GROW checklist.