Objective To investigate the diagnostic value of serum tumor markers carcinoembryonic antigen (CEA) ,neuron spe-cific enolase(NSE) ,cytokeratin-19 fragments(CYFRA21-1) ,squamous cell carcinoma antigen(SCCA)in the lung cancer .Methods By using electro chemiluminescence immunoassay ,the concentrations of CEA ,NSE ,CYFRA21-1 and SCCA were determined in 98 cases of lung cancer and 30 cases of healthy control group ,and the positive rate ,sensitivity ,specificity ,accuracy were calculated .Re-sults In different lung cancer pathological groups ,the concentrations of the 4 serum tumor markers were significantly higher than the control group(P<0 .05) .CEA had the highest diagnostic sensitivity for detecting adeno carcinoma ,NSE had the highest diag-nostic sensitivity for detecting small cell lung cancers ,CYFRA21-1 had the highest diagnostic sensitivity for detecting squamous carcinoma .The combined tests of four serum tumor markers had higher diagnostic sensitivity and accuracy than single test for lung cancers .Conclusion The four serum tumor markers are valuable in the pathological classification ,diagnosis and differential diagno-sis of lung cancer .The diagnostic sensitivity and the accuracy are obviously higher in combined tests .

Objective To determine the effects of sexual hormone therapy at varied doses on prevention of bone mineral loss in Chinese postmenopausal women. Methods From March 2002 to March 2003, 90 Chinese postmenopausal women were randomly divided into three groups, each given one of the following regiments for 12 months, estradiol valerate (EV) 1 mg plus medroxyprogesterone (MPA) 2 mg for group A (31 subjects), eonjngated estradiol (ethinylestradiol-3-cyclopentylether, CEE) 0.45 mg plus MPA 2 mg for group B (29 subjects) and livial 1.25 mg for group C (30 subjects), respectively. In addition, 400 mg of elemental calcium were given daily to all those women. Bone mineral density (BMD) of the 2nd to 4th lumbar vertebra (L2～4) and biochemical markers of bone turnover, urine N-telopeptide of type Ⅰ collagen/creatinine(NTX/Cr) and serum total alkaline phnsphatase (ALP), were measured before and after drug administration. Results After treatment for 12 months, BMD of the L2～4 increased significantly by 0.039 g/cm2(P<0.01) in group B, but not significantly in group A or group C (P<0.05). Increases in BMD of the L2～4 was more in group B than that in group A and group C, respectively (P < 0.05), but no significant difference in BMD increase between group A and group C was found (P >0.05). After treatment for 6 months, urine NTX/Cr reduced from the baseline for all the three groups (P < 0.05), but no significant difference among group A, group B and group C was found (P >0.05). After treatment for 12 months, serum ALP significantly reduced from the baseline for all the three groups (P <0.01), but no significant difference among group A, group B and group C wag found (P > 0.05). Conclusions Sexual hormone therapy at varied doses lower than regular one for 12 months was effective in preventing bone mineral less in postmenopausal women.

Objective To investigate clinical service delivered at the Polyclinic of Beijing 2008 Olympic and Paralympic Village and outcomes of the medical patients visited there.to provide experiences in medical care service for other mass-gatherings in the future.Methads Clinical data of all the medical patients evaluated at the Polyclinic during July 27 to August 27 and during August 29 to September 19,2008 were reviewed retrospectively.with univariate and multivariate analyses.Results In total.1537 and 1206 medical patients visited the Polyclinic at the Olympic and Paralympic Village,respectively.Proportion of athletes visited was hisher during the Paralympic Games than that during the Olympic Games(14.2% vs.9.8%,P<0.01).We reeeived 775 patients(50.4%)with acute respiratory tract disorders,including 16 cases(1.0%)with asthma,during the Olympic Games,and 686(56.9%),including eight cases (0.7%)with asthma,during the Paralympic Games,and antibiotics were prescribed for 149(9.7%)and162(13.4%)of them,respectively.Twelve(0.8%)patients were hospitalized during the Olympic Games and four(0.3%)during the Paralyrnpie Games,and age equal to or nlore than 55 years and digestive disease were independent risk factors for hospitalization,with odds ratios(ORs) of 5.3 and 9.5 and their 95% confidence intervals(Cls)of 1.4-19.6 and 2.5-36.4,respectively.Conclusions Acute respiratory disorder was the most connnon cause for medical visits in the Polyclinic.Asthma did not play a significant role to iniluence athletes'performance in the Beijing 2008 Olympic and Paralympic Games.Antibiotic prescription in the Polyclinic had been controled to an acceptable level.Conditions in elder patients and those with digestive disorder tended to be severe.deserving more attention infuture's mass gathering.

Objective To investigate the changes and significances of vaginal microecology in elderly postmenopausal women.Methods 50 postmenopausal women and 68 reproductive age women with no subjective symptoms and normal vaginal microecological who had health examination in Beijing Hospital were selected.The contents and strains of vaginal lactobacilli in both groups were detected by polymerase chain reaction (PCR),and their differences between the two groups were analyzed.Results 92％ (46 cases) of postmenopausal women had only one vaginal lactobacillus strain in vaginal,and 8％(4 cases) of them had two lactobacillus strains in vaginal.But 4％(3 cases) of reproductive-age women had only one vaginal lactobacillus strain in vaginal,and 96％ (65 cases) of them had two and more lactobacillus strains in vaginal.There was a significant difference in the strains of vaginal lactobacilli between the two groups (x2=91.035,P=0.000).The strains of vaginal lacmbacilli ranking top 4 detection rate was Lactobaeillus jensenii (30.0％),Lactobacillus gasseri (22.6％),Lactobacillus crispatus (16.9％) and Lactobacillus inert (13.2％) in postmenopausal women,while Lactobacillus inert (80.8 ％),Lactobacillus crispatus (70.5 ％),Lactobacillus gasseri (67.6％) and Lactobacillus jensenii (39.7％) in reproductive-age women.The content of 16s rDNA from vaginal lactobacillus was more in reproductive age women than in postmenopausal women [(87.3 ±0.8) ng/g total DNA vs.(35.1±3.6) ng / g total DNA,t=6.514,P=0.048].Conclusions Lactobacillus strains colonizing in vaginal are different between postmenopausal women and reproductive age women,and the content of the vaginal lactobacillus is reduced significantly in postmenopausal women.

OBJECTIVE:To systematically evaluate therapeutic efficacies of perioperative application of single-dose and multipie-dose of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation,and to provide evidence-based reference.METHODS:Retrieved from PubMed,EMBase,CBM,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about perioperative application of single-dose (trial group) and multiple-dose (control group) of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation were collected.Meta-analysis was performed using Rev Man 5.3 statistical software after literature screening,data extraction and quality evaluation by improved Jadad.RESULTS:Finally 8 clinical studies were included,involving 3 457 patients.The results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection [OR=1.02,95％ CI(0.63,1.66),P=0.94)].Cefazolin stadies were included in subgroup analysis according to drug use,and results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection[OR=1.33,95％CI(0.55,3.20),P=0.52].CONCLUSIONS:Prophylactic application of single-dose of antibiotics is recommended for preventing surgical site infection after closed fractures patients receive incision and internal fixation.

Objective To observe the effects of cultivation mode of autonomous learning ability in TCM formula on students’ learning capacity and comprehensive quality. Methods On the basis of inheriting the traditional teaching mode, classroom questioning, class discussion, problem-based learned teaching, simulated prescription exercises, autonomous teaching and training, the mid-term oral test, and autonomous proposition consisted of autonomous learning ability training mode diversification. In the teaching process, teachers' teaching was the primary, and was interspersed with cultivation mode of autonomous learning ability. At the end of the teaching activities, questionnaire survey method was adopted to evaluate the autonomous learning ability training mode in the teaching of TCM formula. Results 81.30%-97.74% students believed that this mode is helpful to improve their learning ability and comprehensive quality; 75.87%-98.49% students believed that it is necessary to carry out the mode in the teaching activities; 69.53% students believed that conducting mid-term examination in the form of oral teat is feasible. Conclusion The cultivation mode of autonomous learning ability for TCM formula can stimulate the learning enthusiasm of the students from various angles, raise interest in learning, arouse students’ learning enthusiasm and initiative, and further cultivate autonomous learning ability and clinical thinking ability, which can provide references for the teaching reform of TCM formula.

Objective To investigate the expression of different inflammatory variables,such as procalcitonin(PCT),C-reactive protein (CRP),D-dimer (DD),fibrinogen (FIB),white blood cell (WBC),neutrophils and platelet(PLT)in septic elderly female patients with bacterial bloodstream infection,in order to assess the early diagnostic value of these variables.Methods A total of 308 elderly female patients with systemic inflammatory response syndrome(SIRS)were enrolled for this prospective study in Beijing Hospital between January 2014 and December 2015.Patients were divided into the sepsis group(n=210)and non-sepsis group(n=98)based on the diagnostic criteria of sepsis.The early inflammatory variables in blood,including PCT,CRP,DD,FIB,WBC,neutrophils and PLT,were detected within 6 hours of bloodstream infection,and their correlations were analyzed.The receiver operating characteristic(ROC)curve of inflammatory variables for the diagnosis of bloodstream infection was plotted,and the area under ROC curve (AUC)was calculated and used to evaluate diagnostic value for bloodstream infection.The best diagnostic cut-off points were identified based on the best(largest)AUC and the best sensitivity and specificity of inflammatory variables for bloodstream infection.Results The levels of all the inflammatory variables were significantly higher in the sepsis group than in non-sepsis group(all P＜0.05).Additionally,PCT and CRP were independent factors for diagnosis of blood stream infection.AUC of the combination of two biomarkers of PCT and CRP was 0.694 for diagnosis of sepsis,which was higher than the either biomarkers alone with AUC of 0.628 for PCT and 0.627 for CRP.The combination group of PCT and CRP showed better values of sensitivity,specificity,positive predictive,and negative predictive (86.2 ％,59.1％,65.1 ％,81.3 ％),as compared with those used individually(63.4％,58.2％,60.3％,61.4％ for PCT;and 62.4％,58.2％,59.9％,60.7％ for CRP,respectively).Conclusions The combination assay of PCT and CRP enhances the diagnostic ability for bacterial bloodstream infection.

Objective To evaluate the value of hysteroscopy in elder women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium.Methods Fifty-three cases in the AUB group and seventy-eight cases in the endometrial hyperplasia group underwent hysteroscopy examination and hysteroscopy-guided biopsy,then the hysteroscopic and histopathological results were compared between the two groups.Results Of the 131 cases,the normal endometrium accounted for 29.8％ (n=39),endometrial polyp for 49.6％ (n=65),submucous myomas for 4.6％ (n=6),hyperplasia endometrii for 6.1％(n=8) and endometrial carcinoma for 9.9％ (n=13).Both the AUB group and theendometrial hyperplasia group had 8 cases of endometrial carcinoma (15.1％,6.4％,respectively).For the diagnosis of normal endometrium with hysteroscopy,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) were 88％,97％,94％ and 95％,respectively,in the AUB group,versus 82％,95％,86％ and 93％,respectively,in the endometrial hyperplasia group.For the endometrial polyps,hysteroscopy showed a sensitivity,specificity,PPV and NPV of 100％,79％,74％,100％,respectively,in the AUB group and 98％,88％,92％,97％,respectively,in the endometrial hyperplasia group.For the endometrial cancer,hysteroscopy had a sensitivity,specificity,PPV and NPV of 75％,100％,100％ and 96％,respectively,in the AUB group;while in the endometrial hyperplasia group,the sensitivity was 80％,the specificity and PPV were 100％,and the NPV was 99％.Conclusions In elder females,hysteroscopy allows for an accurate diagnosis in endometrial disease,and hysteroscopically directed sampling is mandatory,even if the uterine cavity appears normal at hysteroscopy,to rule out endometrial neoplasms.

Objective:To investigate the association between indoleamine 2,3-dioxygenase(IDO)expression in tumor tissue,its periph-eral blood activity, and the efficacy of neoadjuvant chemotherapyin patients with breast cancer. Methods: Immunohistochemistry (IHC)and high-performance liquid chromatography(HPLC)were used to measure IDO protein expression in tumor tissue,and kynuren-ine(Kyn),tryptophan(Trp),and IDO activity(Kyn/Trp)in peripheral blood before neoadjuvant chemotherapy in 53 patients with breast cancer from Tianjin Medical University Cancer Institute and Hospital between September 2015 and December 2016.The correlations between the expression and activity of IDO and the efficacy of chemotherapy were analyzed.Results:In tumor tissue,IDO expression-before neoadjuvant chemotherapy was related to clinical tumor stages(P=0.006),node stages(P=0.020),clinical stages(P=0.045),and estrogen receptor(ER)status(P=0.014).High IDO activity before neoadjuvant chemotherapy in peripheral blood was associated with high IDO expression in tumor tissue(P=0.004),and was also correlated with clinical tumor stages(P=0.019)and node stages(P=0.047). Univariate analysis showed that the clinical efficacy of neoadjuvant chemotherapy was associated with pre-chemotherapeutic clinical tumor stages(P=0.049),ER status(P=0.025),and molecular subtype(P=0.014),while pathologic complete response(pCR)was related to pre-chemotherapeutic clinical tumor stages(P=0.014).Importantly,the clinical efficacy of neoadjuvant chemotherapy and pCR were both related to IDO expression and activity before chemotherapy(all P<0.05).Multivariate analysis showed that pre-chemotherapeu-tic IDO activity in peripheral blood was the only independent factor that affected pCR(P=0.032).Conclusions:Tumor tissue IDO expres-sion and peripheral blood IDO activity before chemotherapy were associated with chemotherapy efficacy,and could provide promising information for the clinical prediction of chemotherapy sensitivity.

Objective To investigate the value of permeability surface (PS) in predicting hemorrhagic transformation (HT) in acute ischernic stroke (AIS) using CT peffusion (CTP).Methods The study included 31 consecutive patients who presented symptoms suggestive of an AIS for 3-9 h. All patients underwent CT examination (noncontrast CT,CTP).HT was determined by follow-up CT images.According to presence of HT,the AIS was divided into HT group (PSHT,11 patients) and non-HT group(PSNo-HT,20 patients).PS,cerebral blood flow (CBF),cerebral blood volume (CBV) and mean transit time (MTT) on both sides of brains were measured.The relative PS(rPS),relative CBF (rCBF),relative CBV(rCBV) and relative MTT(rMTT) were obtained by calculating the ratio of the values of bilateral regions.The rPS between PSHT and PSNo-HT was compared with an exact Wilcoxon signed-rank test. The rCBF,rCBV,rMTT and the PS of the ischemic side between PSHr and PSNo-HT were compared with independent-sample t test.Meanwhile,Spearman rank correlation analysis was conducted to analyze the relationship between the CTP parameters and HT.ResultsThe PS value of ischemic side was (1.61±0.77) ml · min - 1 · 100 g-1 for the PSHT group,and the value was (0.91 ± 0.49) ml · min - 1 · 100 g- 1 for the PSNo-HT group.For the PSHT group,rPS,rCBF,rCBV,rMTT were 2.76 ±0.78,0.32 ±0.18,0.66 ±0.31,2.67 ±0.71,and for the PSNo-HT group,rPS,rCBF,rCBV,rMTT were 1.35 ±0.19,0.50±0.21,0.91 ±0.28,2.62 ± 1.31.Compared with PSNo-HT,PSHT had higher rPS and PS value,and there were significant statistical differences (U =0.000,t =3.070,P ＜0.01).But rCBF and rCBV values were lower in the PSHT group compared to the PSNo-HT group,and there were significant statistical differences (trCsF =2.343,trCBV =2.210,P ＜ 0.05).There was no significant statistical difference in rMTT between the two groups(t =0.118,P ＞ 0.05).Significant positive correlations were detected between the rPS and PS with HT(r=0.496,0.821,P ＜0.01).ConclusionsThe value of rPS is helpful in predicting HT in AIS.And it can be used as a predictor in determining clinical personalized treatment and thus reduce the incidence of adverse events.