The research of esophageal target is a difficult spot in the precise radiotherapy and the target mobility has an important effect for the radiotherapy of esophageal cancer.By different breathing control techniques,controlling the patient's respiratory may narrow target mobility so as to improve the accuracy of radiotherapy.But the present studies of the movement range of esophageal cancer with the respiratory control technologies have not come to a consistent standard.The area shape and position change of esophageal cancer target is a key problem that needs to be solved in the esophageal precise radiotherapy.

As a transcriptional repressor,Bmi-1 is a member of polyeomb group gene family.It may play an important role in self-renewal ability and proliferation of stem cell.At present,studies show that Bmi-1 is highly expressed in a variety of solid tumors,which can be regarded as one of the markers of cancer stem cells and has a close relation to the cancer development and progression and radiation resistance.It will provide an important target gene for the treatment of malignant tumors.

Objective To explore the correlation between adiponectin/leptin(A/L) ratio and metabolic syndrome diagnosis in elderly men. Methods A total of 256 elderly men (≥60 years) were enrolled and divided into metabolic syndrome group(n= 109) and non metabolic syndrome group (n= 147). Serum levels of adiponectin and leptin were measured by radioimmunoassay (RIA) and the A/L ratio was calculated. Metabolic syndrome diagnosis is based on the definition provided by China Diabetes Society (CDS) in 2004. Results (1) In metabolic syndrome group versus non metabolic syndrome group, the serum levels of leptin and adiponectin were (10. 3±7.0) vs (6.8±4.9)μg/L and(7.8±5.6)g/L vs (9.5±5.9)g/L, and A/L ratio was 0. 94±0. 78 vs 2.15±2.13 respectively. (2) A/L ratio was positively correlated with high density lipoprotein cholesterol (HDL-C) and negatively correlated with body mass index (BMI), triacylglycerol (TG) and serum uric acid(P< 0. 001). (3) The higher value of A/L ratio, the lower possibility of metabolic syndrome. When the A/L ratio was more than 5, the incidence of metabolic syndrome was decreased to O(X2 =34. 891 ,P< 0.001). (4) The more components of metabolic abnormality, the lower value of A/L ratio(F= 10. 876,P<0. 001). Conclusions The A/L ratio may be useful in evaluating the extent of metabolic disorder and diagnosing metabolic syndrome in elderly men.

Objective To investigate the problems existing in hospital transfusion records,analyze unreasonable factors,and improve the quality of blood transfusion.Methods Investigation of our hospital from January 2016 to January 2017 with blood transfusion medical records,according to hospitalization number,900 cases were selected,using random number table.Investigating blood transfusion records on each record integrity,according toGuidelines for Surgical and Traumatic Blood Transfusion and Internal medicine transfusion guide in clinical blood transfusion technical specifications.The common blood components such as red blood cells,plasma and cryoprecipitate infusion and rationality evaluation.Results There were 583 surgical departments and 557 non-surgical departments.There was a significant difference between the surgical department and the non-surgical department.The reasonable rate of non-operation department was higher than that of the operation department (x2 =7.723,P=0.021).The rational rate of the department was 93.8％,while the operation department was only 88.0％;900 blood transfusion records of four kinds of blood components of the rationality of the difference was statistically significant (x2=214.767,P＜0.001).Non-surgical department of erythrocyte,plasma,cold precipitate reasonable rate than the surgical department;900 medical records in 55 records failed,mainly after the assessment of incomplete blood transfusion,no recorded blood transfusion reaction.There were significant differences in the failure rate between the surgical department and the non-surgical department (x2 =4.613,P=0.032).Conclusion Some physicians transfusion indications,for evaluation before and after blood transfusion blood insufficient attention to curative effect evaluation,blood transfusion is not reasonable,and in the operation department,do not take the blood transfusion medical record writing,hospitals should strengthen the blood transfusion blood transfusion continuously improve the scientific and normative management.

Objective To develop a HPLC-MS/MS method for determination of Imatinib and Dasatinib in CML patient,and make it used in clinic trial.Methods The separation was performed on a Ultimate XB-C18 column with a mobile phase of water(containing 2 mmol/L ammonium acetate and 0.1 ml/dl formic acid)and methanol(containing 0.1 ml/dl formic acid). The way of eluting was gradient.Mass spectrum detection method was ESI positive ion mode and monitoring Imatinib m/z 494.5>394.3 and Dasatinib m/z 488.3>401.3.Results The standard curve of Imatinib was linear over the range of 0.05~7.5 μg/ml,Y =5.6×105 X+5× 103 (R =0.999 8).Thestandard curve of Dasatinib was linear over the range of 5~250 ng/ml,Y =211X+66.6(R=0.999 6).The relative recovery was among the range of 90%~107%.RSDs of intra-and inter-day validation were less than 10%.Conlusion This method is convenient,accurate and rapid,and can be used for the deter-mination of Imatinib and Dasatinib in clinic test.

Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P<0.05). While there was no statistically significant difference in the incidence of placental abruption, anemia in pregnant women, or fetal distress among the three groups (P>0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P<0.05). The incidence of the pregnancy complications in the TPOAb (+) treated group was higher than those in the control group, but the differences were not statistically significant (P>0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy. Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P<0.05). While there was no statistically significant difference in the incidence of placental abruption, anemia in pregnant women, or fetal distress among the three groups (P>0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P<0.05). The incidence of the pregnancy complications in the TPOAb (+) treated group was higher than those in the control group, but the differences were not statistically significant (P>0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy.

OBJECTIVE: To investigate the resistance phenotype of acinetobacter baumannii and the expression of ade efflux pump gene. METHODS: Non-repetitive 51 strains of Acinetobacter baumannii were collected in Peking Union Medical Hospital between Feb. 2004 and Feb. 2005. The active efflux system adeB structural gene and sequence were identified by PCR. RESULTS: The tested strains were not susceptible to common broad-spectrum antibiotics. Multidrug resistant Acinetobacter baumannii carried adeB active efflux pump gene. CONCLUSION: The multiple-drug resistance of Acinetobacter baumannii is independent of ?-lactamase. It maybe related to other drug resistance mechanism. The effect of active efflux system is possibly one of the major mechanisms of multidrug resistance of acinetobacter baumannii.

The effect of cholesterol ester transfer protein(CETP) on SR-B1 mRNA expression in mouse liver was investigated.The results demonstrated that CETP transgenic mice showed lower serum total cholesterol and high density lipoprotein-cholesterol levels but higher total cholesterol and cholesterol ester content in liver when compared with wild type mice(P＜0.05).The expression of SR-B1 mRNA in liver of CETP transgenic mice was significantly lower as compared with the control group(P＜0.05).

Objective To analyze the correlation of characteristics of carotid artery structure and the incidence of residual stenosis after carotid artery stent (CAS) placement and its influencing factors using color Doppler flow imaging (CDFI).Methods Five hundred and ninety-six cases from January 2013 to December 2015 who underwent CAS (600 pieces of stent) were included in this study.All patients were examined by CDFI within 1 month before and 1 week after carotid artery stenting.The incidence of residual stenosis was analysed.The correlation of residual stenosis and the characteristics of carotid artery lesions and atherosclerotic plaque before stenting were analyzed respectively.Results There was positive correlation between the incidence rates of residual stenosis and irregularly shaped plaque (odd ratios,9.02;95% confidence interval,5.21-15.59,P<0.05),the plaques with calcification in the surface(odd ratios,2.55;95% confidence interval,1.45-4.49,P<0.05),the residual diameter of carotid stenosis less than 1.0 mm(odd ratios,1.61;95% confidence interval,1.06-2.45,P<0.05),which were the independent risk factors for influencing residual stenosis after CAS.Conclusions Choosing a more adaptable stent based on the characteristics of carotid artery lesions and atherosclerotic plaque by CDFI before stenting may be useful for the patients to get best result of revascularization.The rate of residual stenosis may be decreased.

Peking University Third Hospital is one of the first hospitals for experiments in clinical pathway selected by the Ministry of Health,which keeps optimizing the clinical pathway management mechanism and function of information system in its 4-year practice.This article described the combination strategy of clinical pathway management and information system applications,in terms of reasonable design of the management plan,standardized clinical pathway,strengthened execution control and improvement of the quality control.The purpose is to balance the relationship between clinical pathway management norms and user-friendliness of the system,enhance rationality and feasibility,improve efficiency and provide high-quality service to ensure medical safety.