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OBJECTIVE@#To explore the genetic basis for a fetus with autosomal recessive polycystic kidney disease (ARPKD).@*METHODS@#Fetal tissue and peripheral blood samples were respectively obtained from the abortus and the couple. Following extraction of genomic DNA, genetic testing was carried out.@*RESULTS@#The fetus was found to carry compound heterozygous variants of the PKHD1 gene, namely c.5336A>T (p.N1779I) and c.9455delA (p.N3152Tfs*10), which were respectively inherited from the husband and wife.@*CONCLUSION@#The c.5336A>T and c.9455delA variants of the PKHD1 gene probably account for the ARPKD in the fetus. Above results have enabled genetic counseling and prenatal diagnosis for the couple.
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Objective:To investigate the progress and prognosis of cervical high-grade squamous epithelial lesion (HSIL) in pregnancy and its effects on pregnancy outcome.Methods:Eighty-five pregnant women who were complicated by cervical HSIL and accepted prenatal care and delivered in Shanghai First Maternity and Infant Hospital from January 2013 to December 2017 were retrospectively recruited as case group. Another 85 pregnant women without cervical lesions were recruited as control. The progress and outcome of cervical HSIL in the case group and the association with delivery mode were analyzed. The pregnancy outcomes were compared between the two groups by two independent sample t-test, Chi-square test or Fisher's exact test. Results:In the case group, the regression rate of cervical HSIL was 29% (25/85) with 10 cases regressing to low-grade squamous epithelial lesion or atypical squamous epithelial cells of undetermined significance and 15 to chronic cervical inflammation; the persistence rate was 64%(54/85); and the progression rate was 7%(6/85). All six progressed patients gave birth to alive babies and one case progressed to invasive cervical cancer and five to HSIL with micro-invasive cervical cancer after delivery. There was no significant difference in the progression rate [7%(4/60) vs 8%(2/25)], regression rate [32%(19/60) vs 24%(6/25)] or persistence rate [62%(37/60) vs 68%(17/25)] between vaginal delivery and cesarean delivery women ( χ2=0.509, P=0.775). The incidence of premature birth of the HSIL group was higher than that of the control group [9%(8/85) vs 1%(1/85), Fisher's exact test, P=0.017], while there were no significant differences in the incidence of other complications or adverse pregnancy outcomes such as intrauterine fetal death, preterm premature rupture of membranes, low-lying placenta, amniotic fluid contamination of Ⅱ-Ⅲ degree, placental abruption, oligohydramnios and fetal distress between the two groups (all P>0.05). Conclusions:The progression rate of HSIL during pregnancy is low. Thus, a close follow-up could be conducted if invasive carcinoma is ruled out and the postpartum treatment should base on pathological results. HSIL during pregnancy could increase the risk of preterm labor, but is not an indication of cesarean section.
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Objective To investigate the influence of symptom incidence,severity,symptom clusters and related interference on the daily activities of colorectal cancer patients during the chemotherapy.Methods A sample of 112 colorectal cancer patients during the chemotherapy has been presented by M.D.Anderson Symptom Inventory (MDASI-GI) of Chinese Version.Exploratory factor and regression analysis are utilized to discuss influence of symptoms on the daily activities of patients.Results For patients with colorectal cancer after chemotherapy,the high incidence of symptoms are successively fatigue [99.1％ (111/112)],sadness [98.2％ (110/112)] and changes in taste [97.3％ (109/112)].Meanwhile,the severe symptoms are successively fatigue [92.8％ (104/112)],disturbed sleep [92.0％ (103/112)] and dry mouth.Furthermore,four symptom clusters are identified as upper-gastrointestinal symptom cluster,emotional symptom cluster,fatigue-related symptom cluster and excretion-related symptom cluster which possess statistical significance to the daily activities of patients (R2=0.782,F=96.071,P＜0.01).They were effective predictors factors of symptom distress.Conclusions Due to high relapse rate and severe condition,colorectal cancer patients during chemotherapy suffer from multiple symptoms which affect seriously daily activities of patients.Consequently,Medical staff should give prompt and accurate assessment,and then take specific intervening measures to alleviate the patients' symptom so as to improve patients' living conditions.
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Objective To explore the relationship between postoperative cancer-related fatigue and nutritional risk in patients with colorectal cancer. Method Using convenience sampling method, 159 postoperative colorectal cancer patients were interviewed with cancer-related fatigue scale and PG-SGA 7 days after operation. Results The average score of CRF was (21.28 ± 6.06). The score by PG-SGA was (15.18 ± 5.55). About 94.34%patients were in need of nutritional intervention. The postoperative cancer-related fatigue was positively related to PG-SGA scores(all P<0.05). Conclusions The postoperative colorectal cancer patients are at a high risk of malnutrition, with nutrition risk positively related with somatic cancer-related fatigue. The clinical nursing staff should pay attention to the nutritional status of patients and correct their malnutrition so as to reduce the symptoms of cancer-related fatigue.
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Objective To investigate the effects of self-efficacy-oriented nursing intervention on postoperative quality of life of lung tumor patients. Methods Ninety patients with lung tumors undergoing chest surgery in our hospital from March 2010 to March 2012 , involved in the study. The nursing data were retrospectively analyzed for investigation of the nursing strategies. The patients were randomized into two group with random digits table in equal number: The control group received routine nursing and the intervention group with self-efficacy-oriented nursing intervention beside routine nursing care. 3 months after nursing intervention , the two groups were compared by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) in terms of quality of life and psychological state. Results The scores of the intervention group by SDS and SAS were both significantly higher than those of the control group (P < 0.05). The scores of the intervention group on self efficacy and quality of life were significantly higher than those of the control (P < 0.05). Conclusion The self-efficacy-oriented nursing intervention applied in the postoperative nursing care to lung cancer patients can significantly improve the postoperative symptoms and psychological status. It can also improve their self efficacy and then enhance their quality of life.
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Objective To investigate health behavior of senile patients with hypertension and influencing factors.Methods Using general data scale,health conception scale,self-rated abilities for health practice scale and health-promoting lifestyle profile,206 patients with hypertension in the clinic and inpatient department were selected by convenience sampling method to investigate their health behavior.Results The score of health behavior of senile patients with hypertension was (72.25±16.66),23.8％ of patients were at high level.Among the subscale of health-promoting lifestyle profile,the score of nutrition was the highest,activity and healthy responsibility were the lowest.The score of health promotion was positively correlated with health conception,self-efficacy and education level,while negatively correlated with unhealthy habits.Conclusions Education about activity and healthy responsibility should be enhanced,we should set up right health conception,develop effective measures to enhance self-efficacy in order to improve health behavior of older patients with hypertension.
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OBJECTIVE To explore the clinical and etiological characteristics in patients with ventilator-associated pneumonia(VAP) in emergency intensive care unit(EICU),and improve the prevention and treatment level of VAP.METHODS To analyze the clinical information of 54 patients with VAP,and to compare the clinical information with the incidence rate of VAP.Bacterial culture of airway secretion and drug sensitive test were used to analyze etiology.RESULTS Totally 148 patients were enrolled in this study,of which 54 were diagnosed as VAP.The incidence rate of VAP group was 36.5%.Respirator used time of VAP group was obviously longer than that of non VAP one.Antibiotic prophylaxis could not lower the incidence rate.A total of 59 pathogen strains were isolated by bacteria culture.The major pathogenic bacteria in VAP were Pseudomonas aeruginosa(22.0%),Acinetobacter baumannii(16.9%),Staphylococcus aureus(15.3%),Escherichia coli(10.1%),and Klebsiella pneumonia(10.1%).CONCLUSIONS VAP is one of the significant reasons for failed mechanical ventilation treatment.To prevent and treat VAP should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.
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OBJECTIVE To explore the nursing intervention of lower respiratory airway bacteria(LRAB) isolated from patients with mechanical ventilation.METHODS A total of 72 stains of LRAB were isolated from mechanical ventilation patient and nursing intervention were analyzed.RESULTS The major pathogenic bacteria were Pseudomonas aeruginosa(22.3%),Acinetobacter baumannii(18.1%),Staphylococcus aureus(16.7%).CONCLUSIONS To control infection effectively,effective sterizing measures must be carried out,especially attention to EICU management,sterilizing of the breathing circuit and management of artificial respiratory airway.
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@#ObjectiveTo investigate the tossing and turning time of the stuporous patients while using the bedsore mat blowing out gas.Methods45 cases were as the control group and treated with routine nursing. 117 cases were as the test group, in them, 17 cases were tossed and turned once every 2 hours, 50 cases tossed and turned once every 4 hours and 50 cases tossed and turned once every 6 hours. The patients of the test group were nursed with the bedsore mat blowing out gas as well as routine nursing. The rates of bedsore of two groups were compared.ResultsThe bedsore rate of the control group was 4.44%, 2 hours group was 0%, 4 hours group was 4% and 6 hours group was 22%; there was no significant difference among the control group, 2 hours group and 4 hours group, but there was a significant difference between 2 hours group, 4 hours group and 6 hours group (P<0.01).Conclusion4 hours is suitable for the stuporous patients to toss and turn while using the bedsore mat blowing out gas.
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OBJECTIVE: To establish a SPE-HPLC method to determine the whole blood concentration of sirolimus.METHODS: The blood sample was treated on Waters OASIS SPE column in which a Supelcosil LC-18DB chromatographic column(250 mm?4.6 mm,5 ?m) was adopted and the temperature was set at 50 ℃.The mobile phase was a mixture of methanol and water(75∶25) at a flow rate of 1.5 mL?min-1.The UV detector was operated at 276 nm.RESULTS: The assay procedure was shown to produce linear calibration curves over the range 1.25～70 ng?mL-1 of sirolimus in blood(r=0.999 7).The limit of detection was 0.5 ng?mL-1.Within the range,the average recovery rate was(101.7?2.7)% and the extraction recovery rate was≥82.8%.The coefficients of variation within a day and between days did not exceed 4.0% and 5.4%,respectively.CONCLUSION: This method is found to be easy,convenient and precise for fast monitoring of plasma concentration of sirolimus.
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OBJECTIVE:To evaluate the situation and the tendency of antihypertensive use in guangdong province.METHODS:The sales volume,defined daily use(DDDs)and daily expense of antihypertensive from2002to2004in guangdong province were investigated and analyzed.RESULTS:The sales volume of antihypertensive from2002to2004had been in?creasing.Calcium antagonist dominated over all other antihypertensives in respect of sales volume and DDDs.CONCLUSION:Calcium antagonist dominate in the antihypertensive market in guangdong province.
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OBJECTIVE To investigate the breathing circuit bacteria and the lower respiratory airway bacteria(LRAB) isolated from mechanical ventilation patient. METHODS A total of 48 strains of the breathing circuit and 87 strains of LRAB from mechanical ventilation patients were analyzed. RESULTS The main organism in the breathing circuit were Pseudomonas aeruginosa(31.2%),and Stenotrophomonas maltophilia(27.2%).The main organisms in LRAB were P.aeruginosa(37.9%),Klebsiella pneumoniae(17.3%) and Candida albicans(13.7%).The pathogens of the breathing circuit were 73.3 % similar with those of LRAB. CONCLUSIONS To control infection effectively,effective sterilizing measures must be carried out,especially attention to sterilizing and managements of the breathing circuit.
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Objective To investigate the expressions, clinical pathological features and prognostic significance of HIF-1?, JNK1 and multidrug resistance proteins: P-gp, MRP1 and LRP in human gastric carcinoma. Methods The tissue microarray technique and immunohistochemical EnVision method were used to detect HIF-1?, JNK1, P-gp, MRP1 and LRP proteins in 135 specimens of gastric carcinoma and 27 gastric mucosa tissues. Results In gastric carcinoma, the positive expression rate of HIF-1?, JNK1, P-gp, MRP1and LRP was higher than that in gastric mucosa tissues (P
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Objective To learn the roles of Helicobater pylori(Hp) colonization in shimofuri lesion formation of degestive tract and its transformation.Method Infective rate of Hp in biopsy specimens of gastric antrum and duodenum,degree of inflammation of the duodenal bulb mucosas were measured,and analyzed relationship of these indexes with Hp colonization in duodenal bulb mucosas,all of patients with shimofuri lesion were randomly divided into ranitidine suppressing acid group(ranitidine group) and anti-Hp therapy group(anti-Hp group),then two groups were secondly observed with gastroscope.Results The positive rate of Hp colonization in duodenal bulb was significantly difference in various phases of the disease(P
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OBJECTIVE:To eualuate the situation and the tondency of antihyperlipidemics used in Guangdong Province.METHODS:The sales volume,DDDs and daily expense of antihyperlipidemics in Guangdong Province from2000to2003were investigated and analyzed.RESULTS:The sales volumes of cardiovascular agents from2000to2003had been increasing.The proportion of antihyperlipidemics to cardiovascular agents in respect of sales volume assumed a decreasing tendency from2001.Simvastatin dominated over all other drugs in respect of sales volume and DDDs.CONCLUSION:HMG-CoA reductase in-hibitor and natural drugs dominate in the antihyperlipidemics market of Guangdong Province.
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OBJECTIVE:To investigate the relationship between Tacrolimus blood concentration and effectiveness after renal transplantation and to find factors affecting Tacrolimus blood concentration METHODS:Steady-state trough concentrations of Tacrolimus were collected from 80 renal transplantation patients RESULTS:The effective blood concentration of Tacrolimus was associated with course of treatment CONCLUSIONS:The therapeutic concentration of Tacrolimus was between 12ng/ml and 15ng/ml during the first 2 weeks after renal transplantation,then should be 8ng/ml～15ng/ml
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OBJECTIVE:To study the centralized dispensing mode in outpatient pharmacy of large hospital METHODS:To establish the label dispensing system and management strategy RESULTS & CONCLUSION:Dispensing is the heart of a pharmacy Good networking system with efficient workflow and rational use of manpower could determine the success in a pharmacy,such as no dispensing error,no illegible handwriting,short wait-time automation of management of drug information and statistics of pharmacist's work load and rise of dispensing efficiency and quality of service
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Objective To study the therapeutic window of rapamycin(RPM) concentration in primary recipients of renal transplantation. Methods An open label, multi center study was performed. One hundred primary renal allograft recipients with cadaveric donors were enrolled from 4 transplantation centers in China. The immunosuppressive regimen was triple therapy,i.e.RPM combined with CsA and steroid. A loading dose of RPM 6 mg/d was administered within 48 hours after transplantation, then a maintaining dose of 2 mg/d was administered. The whole blood concentration of RPM was measured by HPLC method. Results The whole blood concentration of RPM in this group was (6.65?2.75)ng/ml, the 10th and 90th percentile for RPM concentration was 3 2 ng/ml and 10 26 ng/ml,respectively.9 5%(8/84)patients suffered from acute rejection during the 6 month period after transplantation in this study, and the concentration of RPM in these was lower than that in non rejection patients(P=0.001). Hyperlipidemia and liver dysfunction were the most frequently adverse events, and RPM concentration was significantly associated with the concentration of triglyceride. Conclusions 4～8 ng/ml is a suitable level for RPM concentration. Regular drug monitoring and reasonable dose modulation may increase the validity and security of RPM.
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OBJECTIVE:To analyze the situation of antiarrhythmic drugs used in40hospitals of Guangdong Province.METHODS:To investigate antiarrhythmic drugs used during the past three years in aspect to the sum of money of consumption,DDDs and daily cost.RESULTS:The increasing rate of consumption sum of antiarrhythmic drugs during the pe?riod2000～2002has been lowered year by year,while the share of market of domestic drugs showed an increasing tendency,the imported drugs decreased year by year,the drugs produced by joint ventures kept steady.Metoprolol and potassium magnesium aspartate were much more frequently used than others.Metoprolol occupied the first place in the list of sum of mon?ey.CONCLUSION:The marketing of antiarrhythmic drugs will further expand in China and the pharmaceutical factories should strengthen the development of new antiarrhythmic drugs.
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OBJECTIVE:To establish a HPLC method for the determination of 5-fluorouracil in human plasma METHODS:The plasma samples were extracted with ethyl acetate-isopropanol(85∶15,V/V)following precipitation of plasma proteins with ammonium sulfate The solvent was evaporated to dryness under a stream of nitrogen The dry extract was dissolved in mobile phase and then injected into the Diamonsil C18 column(150mm?4 6mm,5?m)and 0 01mol/L KH2 PO4(pH5 5) was taken as mobile phase The flow rate was 1 5ml/min,UV detection wavelength was 267nm The internal standard was 5-bromouracil RESULTS:The minimal detectable drug concentration in plasma was 0 025?g/ml The calibration curve was linear over a range from 0 3?g/ml to 10?g/ml The intra-day RSD≤5 0%(n=5) and the inter-day RSD≤11 5%(n=5) CONCLUSION:The method can be used for studying the pharmacokinetics and bioavailability of 5-fluorouracil