Objective To investigate influence of nutritional status on prognosis in patients with systemic inflammatory response syndrome (SIRS). Methods Retrospective analysis for clinical data of 533 patients who hospitalized at the Internal Medicine Department of Beijing Social Welfare Hospital and the Emergency Department of Chaoyang Hospital, Beijing during 2005 to 2010 were performed. All the patients were divided into SIRS (323 cases) and non-SIRS (210 cases) groups based on diagnostic criteria of SIRS and pyemia, and groups of the survival (431 cases) and the dead ( 102 cases) based on their end outcomes.Patients of SIRS were further divided into sub-groups of pyemia (287 cases) and non-pyemia (36 cases)based on their infection status. The Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ ),serum levels of prealbumin ( PAB), albumin ( ALB), total cholesterol (CHOL) and C-creative protein (CRP) were measured for all the patients on the 1st, 3rd, 7th days after admission, before discharge and prior to death, respectively. Results Scores of APACHE Ⅱ were significantly higher in SIRS and the dead groups than those in non-SIRS and the survival groups (P ＜0. 05 ). Serum level of albumin was significantly lower in SIRS and the dead groups than that in non-SIRS and the survival groups on the 7th day after admission (SIRS vs. non-SIRS: F=9.812, P=0.035; the dead vs. the survival: F =45.285, P=0. 003). Change in serum level of prealbumin was the same as the level of albumin, with significant difference between various groups since the 3rd day after admission ( P ＜ 0. 05 ). Significant time effects could be found in the dead and survival groups (for the dead group: F = 19. 188, P = 0. 000; and for the survival group: F = 47. 250, P ＜ 0. 01 ). Multiple regression analysis showed that serum levels of prealbumin and total cholesterol correlated with scores of APACHE Ⅱ[with a regression formula of scores of APACHE Ⅱ = 52.032-21.407 PAB-8.971 CHOL (R2 =0.801, F=48.016, P =0.023)]. Logistic regression analysis showed that low level of prealbumin and high scores of APACHE Ⅱ both were predictors for survival of SIRS patients, with an overall accuracy of 77. 1 percent, 73.5 percent for survival and 79. 5 percent for death prediction. Conclusions Severe malnutrition can be found in patients with SIRS and serum level of prealbumin can be used to evaluate their nutritional status and severity of the disease. High scores of APACHE Ⅱ combined with low serum level of prealbumin can predict prognosis of the patients.

Objective To observe brain areas activated during verb generation in Uyghur and Chinese,and thus to explore the neural mechanism of speech formation and understanding and the language barriers after brain injury and during recovery.Methods The blood oxygen level dependent contrast functional magnetic resonance imaging (BOLD-fMRI) was used to scan activated brain areas of 31 cases of Uyghur and 28 cases of Chinese speakers as they completed a verb generation task.Results The mainareas activated in the brains of the Chinese group were the left caudate nucleus,the left inferior occipital gyrus,the left fusiformgyrus,bilateral supplementary motor areas (BA8/6),the left BA32 area,the left precuneus,the left superior parietal lobe (BA7),the left inferior parietal lobe,the left angular gyrus,the right precentral area (BA9),the pars triangularis of the left inferior frontal gyrus,the pars opercularis of the right inferior frontal gyrus and the bilateral cerebellum.The main activated areas of the Uyghur group were the left precentral area (BA9),the pars opercularis of the left inferior frontal gyrus,the pars triangularis of the left inferior frontal gyrus and the left cerebellum.Moreover,the Chinese group showed significantlygreater activation in left caudate body,the left orbital part of the middle frontal gyrus,the right caudate head and the bilateral anterior cingulate gyrus (BA32) compared to the Uyghur group.The Uyghur group,on the other hand,did not show activation significantly greater than that of the Chinese group in any area.Conclusions The brain areas activated when generating verbs in Uyghur and Chinese are not exactly the same-the processing of Uyghur mainly occursin the left hemisphere,while that of Chinese may need the participation of more brain areas in the right hemisphere.

Objectives To analyze the mechanisms and implications involved in the generation of platelet associated antibodies in cancer patients.Methods HLA IgG antibody from 116 cancer patients who had received repeated platelet transfusion (more than 3 times) was screened by ELISA and the GTI QUICKSCREEN kit. The positive samples from the initial screening were confirmed for HLA and HPA antibodies using the PAKPLUS reagent. Patients with antibodies were observed for symptoms and clinical effectiveness of platelet transfusions. Results A total of 44 cases of HLA IgG antibody were screened out of 116 samples, with an antibody rate of 37.93%. Among those 44 samples, 18 were confirmed to contain anti-HLA-Ⅰantibody, 8 with anti-HPA antibody, 10 with both anti-HPA and anti-HLA antibodies, and 8 were not identified. The occurrence of antibodies was positively correlated to the times of platelet transfusions and correlated to the improvement of clinical symptoms (P

Objective:To investigate the expression of APRIL in NSCLC and to analyze the relationship between expression of APRIL and clinicalpathological characteristics of NSCLC.Methods:RTQ-PCR and Western blot were used to detect the expression of APRIL mRNA and protein in 68 pair of tumor tissues and corresponding adjacent normal tissues of NSCLC.50 Formalin-fixed,paraffin-embedded NSCLC samples were tested for APRIL protein location and expression by IHC,with results compared to the clinical and pathological parameters of NSCLC to determine significance.Results:The results showed that the expression level of APRIL mRNA and protein in tumor tissues was significantly higher than in normal tissues(both P

Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over.Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed.Patients' clinical characteristics and treatment were analyzed.Results Median survival time of the patients was 6.9 months.92.9％ (13/14) of small cell lung cancer patients and 34.4％ (31/90) of non small cell lung cancer patients were treated.Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months,respectively (P=0.008).In the early stage of tumors,survival time of patients undergoing surgery was 36.7 months,15.5 months in patients without surgery (P=0.023),while in the late stage,survival time of patients receiving combined chemotherapy was 13.4 months,4.6 months in patients receiving single agent chemotherapy(P=0.002).In small cell lung cancer,survival time of patients who received radiotherapy was 12.8 months,6.4 months in patients who did not receive radiotherapy (P=0.049).Performance status (PS),clinical stage,early surgery,late chemotherapy and radiotherapy(x2=38.236,18.831,5.187,9.827,4.186,P＜0.05),but not sex and pathology type affected the prognosis.PS score (P=0.003)and clinical stage(P=0.046) were the independent influencing factors.Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years.Patients may improve survival if receiving surgery,chemotherapy and/or radiotherapy when they have good PS,otherwise patients may choose best supportive care.

Objective To study the effect and mechanism of the neurological function recovery in rats with spinal cord injury (SCI) rats after the transplantation of neural stem cells which are directly differentiated from bone marrow mesenchymal stem cells (BMSC), and to investigate the suitable engraftment time.Methods The BMSC at 3rd passage were differentiated into neural stem cells (NSC), and immunofluorescence staining was used to identify the NSC. The oriented-induced cells were labeled with Brdu 3 days before they were transplanted, and they were slowly injected into the injured site of the SCI rats. The SCI rats were randomly divided into group Ⅰ (transplantation at first week postinjury), group Ⅱ (transplantation at 2nd week postinjury) and control group (the operation was the same as group Ⅰ, but the cell suspension was replaced by the equal volume of normal saline). The BBB scores after transplantation were recorded. The distribution and differentiation of transplanted cells were observed by using immunofluorescence staining with antibodies against Brdu combined with Nestion and Brdu combined with NF200. NF200 immunofluorescence staining was used to show the regeneration of nerve fibers. The pathological changes of the injured site were observed by HE staining.Results The nestin expression was positive after the BMSC were differentiated for 3 days, and if the induced spherical cells were cultured continuously, the different levels of NF200 and GFAP were found. BBB scores in group Ⅰ and group Ⅱ were significantly higher than in control group (P<0.05), especially in group Ⅰ. The immunofluorescence showed that a large number of Brdu and Nestin double-positive cells and some Brdu and NF200 double-positive cells filled the injured site and linked the two sides of the injured area in group Ⅰ and group Ⅱ, and the lesion area of the spinal cord was reduced as compared with control group (P<0.05). More importantly, further reduction in lesion area and improvement in neurological function were observed in group Ⅰ.Conclusion The BMSC can be differentiated into NSC. The transplantation of the NSC could effectively promote the nerve function recovery after SCI, and the effect of transplantation at first week postinjury was better than at 2nd week postinjury.

Objective To study the reliability and validity of an aphasia battery of Uighur (ABU).Methods The Chinese Aphasia Battery (ABC) was translated into Uighur.Appropriate adaptation was made according to the features of Uyghur language,but the overall structure was unchanged.Three rounds of comments and revisions were conducted by experts and the ABU was back-translated into Chinese after language adjustment and pretesting.The ABU was then applied to evaluating 104 cases of stroke aphasia among Uighur speakers,among which 30 cases were retested one week later.The construct validity,internal reliability,retest reliability and splithalf reliability of the scale were tested using factor analysis and Spearman rank correlation analysis.Results The discrepancy between the original and back-translated ABC was less than 10％.The Kaiser-Meyer-Olkin value was 0.917 and the p value of the Bartlett's test for sphericity was ≤0.005.Three common factors were extracted using principal component analysis with a varimax orthogonal rotation:a writing factor;and a listening comprehension factor.Together they explained a total of 81％ of the variance.The Cronbach's α of the components were 0.969 for oral expression,0.922 for listening comprehension,0.966 for reading and 0.924 for writing,giving a total α coefficient of 0.978.The test-retest correlation coefficients of 22 items were greater than 0.8,with only another two below 0.7.The split-half reliability of the scale was 0.906.Conclusions The aphasia battery in Uighur has good validity and reliability,and can quantitatively reflect the functional status and language changes among Uighur's with stroke aphasia.It may also be suitable for application in the clinical rehabilitation of other sorts of Uighurspeaking aphasics.

Objective To establish a scientific,actual and practical training system based competency for different levels of nurses.Methods The candidate training system based competency for different levels of nurses were formulated based on literature,semi-structured interviews and expert group discussion.Then,developing the training system based competency for different levels of nurses by two rounds of Delphi consultation.Results The positivity coefficient and authority coefficient of experts was 97.5％ and 0.868,respectively.The index variation range from 0.063 to 0.137 and the coordination coefficient range from 0.384 to 0.702,P ＜ 0.01 of the two rounds.At last,the framework of the training system included five levels,the index system consisted of four first-level indicators and 22,25,24,25,27 second-level indicators for N0 to N4 nurses.Conclusions The formation process of index and each index is scientific,the index system can be used as basis of training courses for different levels of nurses in the hospital.

Objective To observe the different needs of Uighur and Han stroke patients for oceupational activities using the Canadian occupational performance measure (COPM).Methods The COPM was employed to evaluate 51 stroke patients in hospital before and after treatment.Thirty were from the Han ethnic group and 21 were Uighur.The first evaluation was performed at admission to confirm their occupational activity problems.Interventions were then planned using a patient-centered occupational therapy model.At discharge the second evaluation was performed to assess and compare the effects of treatment.Results In the first evaluation,both the Uighur and Han stroke patients had problems with self-care activities which were more prominent than those with productive and leisure activities.Older Uighur patients had special occupational activity needs resulltng from their religious practices.Compared witb the first evaluation,the total performance and satisfaction scores had improved significantly by the second evaluation for both the Han and Uighur patients,but their satisfaction scores were lower than their occupational activities performance scores.Conclusion Different nationalities may have different occupational activities needs.The COPM is easy to use and helpful in confirming occupational activity problems.Its use can contribute to the plan ning of primary goals for rehabilitation and treatment programs and help assess the effect of rebabilitation.

AIM:To investigate the perfusion parameters using dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI) in rectal cancer patients so as to explore its potential value in estimating the microvascular condition including perfusion and permeability .METHODS:The data of 38 rectal cancer patients examined with DCE-MRI was ret-rospectively analyzed .The perfusion parameters of carcinoma and normal rectal wall in each case were calculated , inclu-ding volume transfer constant (Ktrans), rate constant of back flux (Kep), extravascular extracellular space fractional volume (Ve) and initial area under curve (iAUC).The mean values of tumor and normal rectal wall , mucinous and nonmucinous carcinoma, poorly and moderately-to-well differentiated carcinoma , case with or without lymph node metastasis were com-pared.RESULTS:All the parameters of rectal cancer were higher than normal rectal wall (P<0.01).No significant difference was found between poorly and moderately-to-well differentiated carcinoma in terms of K trans, Kep and Ve, neither was the case with or without lymph node metastasis .The cases with lymph node metastasis had lower iAUC than those with-out (P<0.05).CONCLUSION:Quantitative perfusion DCE-MRI answered the microvascular perfusion and permeability change of rectal cancer compared with normal rectal wall , besides it could be used to distinguish between mucinous and nonmucinous carcinoma , which demonstrated its value in the evaluation of rectal cancer .However , it should not be recom-mended to predict the degrees of tumor cell differentiation and lymph node metastasis just according to the perfusion param -eters.