简介：BackgroundPregnancycomplicatingpulmonaryarterialhypertension(PAH)isalife-threateningobstetricalcomplication.FewstudieshavereportedtheclinicalcharacteristicsandoutcomesofpregnantwomenwithPAH.MethodsRetrospectivelyanalysiswasconductedon86casesofpregnantwomenwithPAHattheDepartmentofObstetricinGuangdongGeneralHospitalbetween2009and2014.Dataincludedpatients'age,theetiologiesofPAH,clinicalclassificationoftheNewYorkHeartAssociation(NYHA),gestationalweeks,deliverymode,maternalandfetaloutcomes.Results1Therewere2casesofidiopathicpulmonaryarterialhypertension(IPAH)and84casesofsecondarypulmonaryarterialhypertension.Thelatterwascomposedby40(47.61%)casesofcongenitalheartdisease(CHD),38(45.23%)casesofrheumaticheartdisease(RHD),3(3.57%)casesofsystemiclupuserythematosus(SLE)and1(1.19%)caseofpartialhydatidiformmole.ThenumberofpatientsclassifiedinNYHAI~IVwere8(9.30%),41(47.67%),26(30.23%)and11(12.7%),respectively.Andthemortalitywas3.48%(3/86).2Amongthe86patients,31(36.04%)womengavebirthattermand36(41.86%)hadprematuredelivery.Inaddition,16(18.6%)womenhadanabortionlessthan28weeks.Therewereatotalof65(75.58%)livebirths,61(93.84%)ofwhomweredeliveredviacesareansection,whiletheother4(6.15%)werevaginaldeliveries.3Patientsweredividedinto3groups,12ofmild(<40mmHg),35ofmoderate(40~70mmHg)and39ofsevere(≥70mmHg)regardingthepulmonaryarterysystolicpressure(sPAP)measuredbyultrasound.WedefinedtheformertwoasgroupAandthelatterasgroupB.Thesignificancewasseenstatisticallyingestationalweeks(32.86±8.86gvs28.76±9.84),therateoftransferringtoICU(19.14%vs53.84%),neonatalbirth-weight(2725.69±467.43vs2044.82±665.75g),APGARscoring(9.97±0.16vs8.68±2.08),maternalstatusofheartfunctionandadversepregnantoutcomes,whencomparedgroupAwithB.AlltheP-valuesmentionedabovew

简介：Transforminggrowthfactor-β(TGF-β)isakeyfactorincancerdevelopmentandprogression.TGF-βcansuppresstumorigenesisbyinhibitingcellcycleprogressionandstimulatingapoptosisinearlystagesofcancerprogression.However,TGF-βcanmodulatecancer-relatedprocesses,suchascellinvasion,distantmetastasis,andmicroenvironmentmodificationthatmaybeusedbycancercellstotheiradvantageinlatestages.Correspondingmechanismsincludeangiogenesispromotion,anti-tumorimmunitysuppression,andepithelial-to-mesenchymaltransition(EMT)induction.ThecorrelationbetweenTGF-βexpressionandcancerprognosishasalsobeenextensivelyinvestigated.ResultssuggestthatTGF-βpathwaycanbetargetedtotreatcancer;assuch,thefeasibilityofthistreatmentisinvestigatedinclinicaltrials.

简介：AIM:Toevaluatetheclinicalusefulnessofendoscopicultrasonography(EUS)forthediagnosisoftheinvasiondepthofulcerativecolitis-associatedtumors.METHODS:Thestudygroupcomprised13patientswith16ulcerativecolitis(UC)-associatedtumorsforwhichthedepthofinvasionwaspreoperativelyestimatedbyEUS.Thelesionswerethenresectedendoscopicallyorbysurgicalcolectomyandwereexaminedhistopathologically.Themeanageofthesubjectswas48.2±17.1years,andthemeandurationofUCwas15.8±8.3years.Twolesionsweretreatedbyendoscopicresectionandtheother14lesionsbysurgicalcolectomy.ThedepthofinvasionofUCassociatedtumorswasestimatedbyEUSusinganultrasonicprobeandwasevaluatedonthebasisofthedeepestlayerwithnarrowingorruptureofthecolonicwall.RESULTS:ThediagnosisofUC-associatedtumorsbyEUSwascarcinomafor13lesionsanddysplasiafor3lesions.Theinvasiondepthofthecarcinomaswasintramucosalfor8lesions,submucosalfor2,themuscularispropriafor2,andsubserosalfor1.Eleven(69%)ofthe16lesionsaroseintherectum.Themacroscopicappearancewasthelaterallyspreadingtumor-non-granulartypefor4lesions,sessiletypefor4,laterallyspreadingtumor-granulartypefor3,semipedunculatedtype(Isp)for2,type1for2,andtype3for1.ThedepthofinvasionwascorrectlyestimatedbyEUSfor15lesions(94%)butwasmisdiagnosedasintramucosalfor1carcinomawithhigh-gradesubmucosalinvasion.The2lesionstreatedbyendoscopicresectionwereintramucosalcarcinomaanddysplasia,andbothwerediagnosedasintramucosallesionsbyEUS.CONCLUSION:EUSprovidesagoodestimationoftheinvasiondepthofUC-associatedtumorsandmaythusfacilitatetheselectionoftreatment.

简介：AIM:Tocomparetheconjunctivalepithelialtoxicitiesofthreenewer-generationfluoroquinoloneswithoutpreservatives.·METHODS:Inaprospective,randomized,doubleblindcomparativestudy,47eyesof47patientswithaprimarypterygiumwereenrolled,anddividedrandomlyintothreegroups(levofloxacin0.5%,gatifloxacin0.3%,andmoxifloxacin0.5%).Afterpterygiumsurgerywiththesameconjunctivalautografttechnique,eachpatientmaintainedaregimenwitharandomlyassignedfluoroquinoloneeyedrop.Patientswereexaminedeveryotherdayaftersurgeryuntiltheepitheliumhadcompletelyhealed.Photosweretakenandusedtomeasuretheareaofresidualepithelialdefects.Conjunctivalhealingtimeandspeed(initialdefectarea/healingtime(mm~2/d)comparedineachgroupusingKruskal-Wallistests.·RESULTS:Therewerenosignificantdifferencesinmeanage,gender,andconjunctivaldefectsizeofthedonorsitebetweenthesegroups.However,themeanofconjunctivalhealingtimeandspeedwerestatisticallydifferentineachgroup.Themeanofconjunctivalepithelialhealingtimewas8.93±2.69d(levofloxacingroup),10.31±2.96d(gatifloxacingroup),and13.50±4.10d(moxifloxacingroup),P=0.006.Themeanconjuctivalepithelialhealingspeedwas6.18±1.39mm~2/d(levofloxacingroup),5.52±1.68mm~2/d(gatifloxacingroup),and4.40±1.30mm~2/d(moxifloxacingroup),P=0.003.·CONCLUSION:Withouttheinfluenceofpreservatives,levofloxacinandgatifloxacinmightbelesstoxictotheregenerationofconjunctivalepithelialcellsandcauseafasterconjunctivalwoundhealingrelativetomoxifloxacin.

简介：Thisreviewstartswithabriefhistoryofdrugdiscovery&development,andtheplaceofAsiainthisworldwideeffortdiscussed.TheconditionsandconstraintsofasuccessfultranslationalR&DinvolvingacademicbasicresearchandclinicalresearcharediscussedandtheSingaporemodelforpursuitofopenR&Ddescribed.Theimportanceofwell-characterized,validateddrugtargetsforthesearchfornoveltargetedanti-canceragentsisemphasized,aswellasastructured,highqualitytranslationalR&D.Furthermore,thecharacteristicsofanattractivepreclinicaldevelopmentdrugcandidatearediscussedlayingthefoundationofasuccessfulpreclinicaldevelopment.Themostfrequentsourcesoffailuresaredescribedandriskmanagementateverystageishighlyrecommended.Organizationalfactorsarealsoconsideredtoplayanimportantrole.Thefactorstoconsiderbeforestartinganewdrugdiscovery&developmentprojectaredescribed,andanexampleisgivenofasuccessfulclinicalprojectthathashaditsrootsinlocaluniversitiesandwascarriedthroughpreclinicaldevelopmentintophaseIclinicaltrials.

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简介：AIM:Todescribetheclinicalfeatures,systemicassociations,treatmentandvisualoutcomesinSaudipatientswithscleritis.·METHODS:AretrospectivechartreviewwasperformedforpatientswithscleritispresentingtotwotertiarycareeyehospitalsinRiyadh,SaudiArabia,from2001to2011.Datawerecollectedontheclinicalfeaturesofscleritis,subtypesofscleritis,associatedsystemicdisease,historyofpreviousocularsurgeryandmedicaltherapy,includingtheuseofimmunosuppressants.Treatmentoutcomeswereevaluatedbasedonbest-correctedvisualacuity(BCVA)andresponsetotreatment.·RESULTS:Ofthe52patientsincludedinthestudy,non-necrotizinganteriorscleritiswasthemostcommontypeofscleritisin22patients(42.3%),followedbyposteriorscleritisin14patients(26.9%).Themajorityofcases,31patients(59.6%),wereidiopathicinnature.Systemicassociationswerepresentin12patients(23.1%).Infectiousscleritiswasconfirmedin6patients(11.5%):3withbacterialscleritisafterpterygiumexcision,2patientswithscleritisrelatedtotuberculosisand1patientwithscleritisresultingfromherpessimplexinfection.Forthevarioussubtypesofscleritis,BCVAvaluesaftertreatmentandtimetoremissionsignificantlydiffered(P<0.05,allcases).Systemicimmunosuppressivetherapiesinadditiontosteroidswereadministeredto46.2%ofallpatients.TheT-signwaspresentonB-scanultrasonographyin9(64.3%)ofthe14posteriorscleritispatients.·CONCLUSION:Non-necrotizinganteriorscleritiswasthemostcommonsubtypeofscleritis.Finalvisualoutcomeandtimetoremissiondifferedamongthevariousscleritissubtypes.

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.

简介：Objective:Tostudythemainclinicalandhistopathologicalfeaturesof12patientswithHodgkin'slymphoma(HL)diagnosedprimarilyfrombonemarrow(BM)involvement.Methods:Weincluded12acquiredimmunodeficiencysyndrome(AIDS)patientswithHLassistedintheF.J.Mu?izInfectiousDiseasesHospitalsinceJanuary2002toDecember2013.ThediagnosisofHLwithprimaryBMinvolvementinpatientswasconfirmedbyclinical,histopathological,andimmunohistochemicalfindings.Results:Allpatientspresented'B'symptomsandpancytopenia.AllofthemhadstageIVneoplasmdiseasebecauseofBMinfiltration.ThemedianofCD4+T-cellcountswas114cells/μL,andmixedcellularity(MC)wasthemostfrequenthistopathologicalsubtypeof92%cases.Conclusion:Whenothercausesareexcluded,BMbiopsyshouldbeperformedinAIDSpatientswith'B'symptomsandpancytopeniatoevaluateBMinfiltrationbyatypicallymphocytes.

简介：摘要针对护理诊断制定护理计划，为提供持续护理、预防或减轻服务对象健康问题而制定护理对策或措施的过程。在计划阶段，护士分析社区存在的健康问题，按问题的严重程度排列顺序，制定护理目标，拟定适当的护理措施并书写护理计划。对制定的护理计划采取的行动，由目标制定者共同努力完成。明确护理活动的效果及服务对象是否朝向预期目标进展。检查护理活动十分恰当、合适。了解问题是否解决。

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简介：摘要目的探讨妇产科护理工作风险，为护理措施的制定提供依据。方法在2013年1月至2015年6月期间我院收治的妇产科患者中，抽选500例作为研究对象。回顾分析产妇的一般资料、分娩方式、护理方法，总结风险事件发生原因，制定并实施针对性的护理措施。结果39例护理风险事件中，发生原因主要是服务观念问题（43.6%）、护理技术问题（28.2%）、护患沟通问题（17.9%）、制度管理问题（10.2%）。结论妇产科护理工作中存在较多风险因素，要求护理人员总结风险发生原因，实施护理措施，来改善护理服务质量，提高患者的护理满意程度。

简介：摘要临床路径是近几年来国外提出的一种诊疗护理新模式，它通过个性化、流程化、标准化的诊疗护理方案，兼顾效益—成本，达到预期的诊疗护理效果，控制病人的医疗费用。本文就临床路径对护理工作带来的积极影响作一探讨与分析。

简介：摘要目的为满足患者住院期间的各种需求，促进患者健康，改进我们现有的工作方法，夯实基础护理，提供优质护理服务。方法结合医院实际，在医院开展优质护理服务示范工程活动，注重夯实基础护理。结果患者对护理服务的满意率达98%，实现了护理零投诉，取得了良好的社会效益。结论夯实基础护理是实现优质护理服务的关键。

简介：摘要目的夯实基础护理，提升护理质量，提高患者满意度，实现优质护理服务。方法院内开展优质护理服务相关活动，夯实基础护理。结果没有针对护理的投诉，护理满意度高，社会效益良好。结论夯实基础护理对于实现优质护理服务具有关键性作用。

简介：摘要目的研究分析在老年脑梗死患者的护理过程中优质护理的积极作用。方法选择在2014年4月-2015年4月期间到院就诊的老年脑梗死患者共计62例作为研究对象，随机将62例患者分成两组，对于常规组患者为实施常规护理，对于研究组患者采用优质护理，比较两组患者经过不同护理方式护理后患者的恢复情况以及患者及其家属对于护理的满意程度，如果两组患者的差异较大，则具有统计学上的意义，P<0.05。结果经过不同的方式进行护理后我们发现两组患者的情况出现了实质性的区别，采用优质护理服务的老年脑梗死患者无论从患者及其家属的满意度还是患者的恢复情况来说都要明显的比对常规组患者好，两组之间存在明显的差异，P<0.05。结论临床研究证明，在老年脑梗死患者的护理过程中采用优质护理服务能够改善患者的情况，值得在临床中推广。