Objective To explore the clinical significance of combined detection of homocysteine (Hcy) and myocardial enzyme spectrum in premature infants with asphyxia ,and provide scientific basis for differential diagnosis and treatment of hyperbilirubi‐nemia in premature infants .Methods A total of 150 cases of premature infants with hyperbilirubinemia hospitalized in this hospital from January 2011 to May 2014 were selected and divided into the mild asphyxia group and server asphyxia group .Other 100 cases of premature infants with physiologic jaundice were selected as the control group .Serum levels of total bilirubin(TBIL) ,homocys‐teine(Hcy) and indicators of myocardial enzyme spectrum were detected and comparatively analysed .Results The levels of TBIL , Hcy and indicators of myocardial enzyme spectrum in the mild asphyxia group and server asphyxia group were higher than those in the control group ,had statistically significant differences(P<0 .05) .Combined with the clinical data and the detection results of col‐or Doppler ultrasound ,3 cases of premature infants with asphyxia complicated with hyperbilirubinemia were diagnosed as myocardi‐tis ,29 cases were diagnosed as subclinical myocarditis and 46 cases were diagnosed as suspected myocarditis .Conclusion Different degrees of myocardial cell damage exists in premature infants with hyperbilirubinemia ,and routine determination of Hcy and myo‐cardial enzyme spectrum have positive significance for clinical diagnosis of neonatal myocarditis and subclinical myocarditis .

The extended service in domestic and foreign medical libraries was summarized according to the trans-formation of medical library and the need of public health information followed by a description of some typical cases of extended service provided by MedlinePlus website , Disaster Medical Information Management Research Center , and patient libraries in order to provide the reference for domestic medical libraries to cary out their extended service .

Objective To investigate the clinical significance of serum ferritin level(SF),serum iron(SI) level in patients with chronic hepatitic B.Methods SF was measured by radioimmunoassay,serum iron was measured through atomic absorption spectrometry.Results Chronic HBV infectors mostly had high level of SF and SI,with severity of illness state increasing,especially in the group of severe hepatitis.The levels of SF and SI correlated with HBV duplication to a certain extent and specifically SF and SI increased with the increase of virus duplication.However,it had no statistical significance.Among the sufferers of hepatocirrhosis,numerical values of SF and SI turned to increase with the rank of Child-Pugh(A,B and C) and SF had the correlation with LN(the index of hepatic fibrosis).Patients of hepatocirrhosis with a high SF level had higher frequency of complications occurrence and reoccurrence,the clinical post-cure effects were worse.Conclusion SF and SI can be reference index in forecasting the degree of disease state,hepatic fibrosis and clinical post-cure.

0.05). The positive rate of HBeAg in genotype C(69.7%) was significantly higher than that in genotype B(42%) (P

Objective To establish a method for detecting chimerism after allogeneic stem cell transplantation using microsatellite polymorphism. Methods DNA was extracted from bone marrow or peripheral blood of 10 recipients and their donors, DNA fragments including 5 microsatellite loci were amplified by PCR, the polymorphism of PCR products was analyzed by PAGE and sliver staining, and the quantitative analysis of chimerism was performed using image analysis software. Results [WTBZ]The five selected STR loci had high polymorphism, and were suitable for detecting chimerism. The sensitivity of sliver staining was 90%. Conclusion Microsatellite polymorphism analysis based on PCR is a sensitive and accurate method to detecting chimerism after allogeneic stem cell transplantation, but the sensitivity of sliver staining was not so good,so more sensitive methods should be used.

Objective To investigate the relationship between hepatitis B virus (HBV) genotype and liver function. Methods The method of microboard nucleate molecular hybridization was employed to detect the genotype in 93 HBV patients of different clinical types and the function of liver. Results Among the 93 HBV patients of different clinical types, there were 24 cases of genotype B (25.81%), 59 cases of genotype C (63.44%), 5 cases of genotype D (5.38%), and 5 cases of mixed type (3 cases of B/D, 2 cases of C/D, 5.38%). Therefore, genotype C took up the largest proportion, followed by genotype B, and then D and mixed genotypes, but there was no genotype A, E or F. The detection rate of genotype C increased according to the sequence of chronic hepatitis B, subacute severe hepatitis and hepatocirrhosis while the detection rate of genotype B decreased gradually. However, the detection rate of genotype C in hepatocellar carcinoma did not rise correspondingly. The levels of ALT, AST and TBIL of genotype C were higher than those of genotype B, but the level of ALB in genotype C was lower than that of genotype B. None of the differences had significance. Conclusion Most of HBV genotypes in Xi'an were C, some of them were B, D and mixed genotypes, but no genotype A, E or F was detected. Except hepatocellar carcinoma, the detection rate of genotype C rose according to the severity of clinical type.

Objective To investigate the value of the multiple short tandem repeat (STR)amplification by fluorescence labeling polymerase chain reaction (PCR) combined with fusion gene bcr-abl mRNA expression for quantitative determination of chimerism and qualitative detection of bcr-abl transcripts,and to evaluate the status of engraftment and predict the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods 5 relapse patients with CML after alIo-HSCT were dynamically investigated. Quantitative analysis of donor chimerism was performed by multiplex PCR amplification of STR markers and capillary electrophoresis with fluorescence detection, qualitative detection of bcr-abl transcripts was performed by RT-PCR. Results The donors alleles appeared in all of 5 patients on day 28 post transplant, and bcr-abl expression was negative. But 5 patients had unstable mixed ehimerism. (DC: 0～80.4 %) at the different time points after aIIo-HSCT and bcr-abl was positive. One of them kept eontinuely the mixed chimerism in the relapse of disease, and died after one year, and the other changed from MC to CC by intervention of clinical treatment. Reduction of donor chimerism were detected prior to the occurrence of graft rejection and disease relapse, while bcr-abl gene expression was positive. Conclusion The results of STR-PCR in the range of its sensitivity fully correspond with bcr-abl tests in patients with CML. The combination of STR-PCR with RT-PCR provides a highly sensitive and valuable tool for engraftment evaluation, graft rejection, relapse and predicting GVHD. Furthermore it can provide a basis for early intervention of clinical treatment, and can identify these patients at high risk with molecular or cytogenetic relapse after allo-HSCT.

Objective To investigate the expression of phosphorylated RB (pRB) in the invasion front of papillary thyroid carcinoma and the clinical pathological implications. Methods Immunohistochemistry was ap-plied in analyzing pRB expression feature and the clinical pathological implications in a total of 82 patients who underwent total or subtotal thyroidectomy and neck lymph node dissection for papillary thyroid carcinoma. Results The displacement of pRB proteins from the nucleus to the cytoplasm was observed in the invasive front of papil-lary thyroid carcinoma , which was an independent predictor of lymph node metastasis in papillary thyroid carci-noma. Conclusion Nuclear-cytoplasmic transport of pRB in the invasive front was an independent predictor of lymph node metastasis in papillary thyroid carcinoma.

Objective To study the relationship between the expression of perforin, granzyme B and the cytotoxicity of NK cells, after NK cells were purified and expanded with different cytokines. Meth-otis It was detected that the mRNA expressions of perforin, ganzyme B from 8 donors, and the cytotoxcity of NK cells to target I(562 cells by competitive qualitative RT-PCR. Results The mRNA expressions of perforin, granzyme B by purified and expanded NK cells with different cytokines were markedly enhanced, and IL-2 +IL-15 group, IL-2 + IL-12 + IL-15 group were significantly higher than others. It is consistent that the relationship between the mRNA expressions of NK cells and the cytotoxicity of NK cells to I(562 cells. Conclusion The mRNA expressions of perforin, granzyme B of NK cells with different cytokines were obviously.

Quality management covers every corner of hospital services,which upholds full-process quality management,continuous quality improvement and smooth management with patients at the center.By means of building a 3-tier quality management framework at the hospital,development of quality management criteria,appraisal indicators and documentation and use of quality management tools,quality management defects were identified from a third-party perspective.This effort has significantly improved quality of care at the hospital,and elevated the management execution and general service quality of the hospital.