Objective To explore the relationship between serum cystatin C concentration and severity of coronary artery disease and prognosis after peripheval component interconnet(PCI)treatment.Methods 352 patients diagnosed as ACS and received PCI treatment successfully were enrolled in the study as ACS group.In addition to that,60 people who underwent coronary angiography and the test results was good were recruited as control group.The serum lipids,cystatin C concentrations were tested,and the rela-tionship between the number of coronary lesions,Gensini score and cystatin C concentrations were analyzed.The risks of major car-diovascular events in different cystatin C concentration groups were analyzed.Results Cystatin C concentrations of ACS group were significant higher than control group (P <0.05).Cystatin C concentrations were significantly different among patients with different number of diseased branches(P <0.05).The patients with higher number of diseased branches were with higher concen-tration of cystatin C.There was a positive correlation between cystatin C concentration and Gensini score (r=0.84,P <0.05).The risk of major cardiovascular events in high cystatin C concentration group within 1 year after PCI treatment increased significantly compared with control group,the OR values were 16.63(95%CI :3.87-71.49,P <0.05).Conclusion Cystatin C correlated with the severity of coronary artery disease and the occurrence of major cardiovascular events within one year after PCI treatment.

Objective To analyze the clinical characteristics of liver metastases of neuroendocrine tumors (NET) and its treatment outcome,so as to further cognition of NET.Methods The clinical data of patients with liver metastases of NET diagnosed by Peking Union Medical College Hospital during January 1996 to July 2010 were analyzed retrospectively.Results The ratio of male to female was 1∶1.15 (20∶ 23).The median age at onset of the patients with liver metastases of NET was 47.5 (26-70) years.The median duration from onset to diagnosis was 4 (0-120) months.The liver metastases were the first manifestation in 69.8％ (30/43) cases.The detection rate of primary lesions with routine abdominal imaging (B-type ultrasonography,CT,MRI) was 65.1％ (28/43),while increased to 90.7％ (39/43) when combined the following one or more special examinations including somatostatin receptor scintigraphy ( SRS),PET-CT,endoscopic ultrasound (EUS) (P =0.004).The definite diagnosis methods mainly depended on surgical specimens (69.8％,30/43).The ratio of nonfunctional to functional NET with liver metastases was 1.87∶1(28∶ 15).The primary tumors were most commonly located in pancreas [39.3％ (11/28) and 73.3％( 11/15 ) ],followed by stomach [ 21.4％ (6/28) and 13.3％ ( 2/15 ) ].Totally 88.4％ ( 38/43 ) patients received operation,and 9.3％ (4/43) patients had reoperation due to missed diagnosis of the primary tumors on earlier operation.Non-surgical treatments included octreotide acetate long-acting release,interventional therapy,chemotherapy and radiotherapy,which were difficult to be evaluated due to less follow-uped cases.Conclusions Liver metastases of NET are common and even the first manifestated symptom.Primary NET with liver metastases is the most commonly nonfunctional and located in digestive system.The detection rates of primary lesions are increased by special examinations including SRS,PET-CT and EUS. Surgical specimens are helpful to the final diagnosis,but it is necessary to improve the preoperative diagnostic rate of primary tumors to avoid repeat surgeries.

OBJECTIVETo explore the curative effect of Z-plasty without skin grafting for correction of cryptotia.

METHODSTwenty-five cases (29 ears) with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia.

RESULTSAll the patients were followed up from 6 months to 1 year with stable and symmetric appearance.

CONCLUSIONSThe shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.

Objective To investigate the role of hexosamine biosynthesis pathway (HBP) in the functionalalterationofmesangialcellstransinfectedwith glucose transporter 1 (GLUT1) gene. Methods Rat mesangial cells were transinfected with the human GLUT1 gene (MCGT1) by retrovirus vector. Mesangial cells transinfected with bacterial ?-galactosidase (MCLacZ) were used as control. Glucose uptake was detected with 2-deoxy-〔 3H〕-D-glucose (2-DG). Cell size, RNA/DNA ratio, protein/DNA ratio and the synthesis of fibronectin were evaluated by flow cytometry. The activity of glutamine: fructose-6-P aminotransferase (GFAT), which is the key enzyme of HBP, was assayed by spectrophotometry. The expression of GFAT gene was analyzed by RT-PCR. Results MCGT1 demonstrated higher 2-DG uptake than MCLacZ 〔(741.0?60.5)dpm/?g protein vs (92.2?9.0)dpm/?g protein,P

Aim To analyze the expression of phosphatidylethanolamine-binding protein(PEBP) and ERK in critical brain regions of psychological dependence rats.Methods Morphine-induced rats conditioned place preference(CPP) model was established to mimic different stages of morphine psychological dependence, during which PEBP expression and ERK activity were assayed in different brain regions.Results PEBP expression in hippocampus, prefrontal cortex, striatum and nucleus accumbens showed no change at three stages of psychological dependence.However, ERK activity increased notably in prefrontal cortex on CPP formation, and decreased remarkably in hippocampus on CPP reinstatement.Conclusions The formation and retrieval of associated memory between morphine effects and environment involve different neural circuits, in which ERK activity is critical, and PEBP might not be involved in such a memory-related ERK regulation.

Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Objective This meta-analysis assessed the value of interferon-γ release assays (IGRAs) in the differential diagnosis of intestinal tuberculosis (ITB) from Crohn's disease (CD).Methods Systematic search without language restriction was conducted in the main computerized databases until June 2015.Studies that have evaluated the performance of IGRAs (QuantiFERON-TB Gold or T-SPOT.TB) in distinguishing ITB from CD were eligible.Main outcome measures included sensitivity and specificity.Area under the curve (AUC) of the summary receiver operating characteristic (sROC) curve was used to evaluate the accuracy of IGRAs.Results Twelve studies (all from Asia) were finally included.The pooled sensitivity and specificity of IGRAs for the differential diagnosis of ITB from CD were 82.8％ (95％CI 78.4％-86.6％) and 86.7％ (95％ CI 83.2％-89.6％) respectively.The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 6.870 (95％ CI 5.345-8.830) and 0.171 (95％ CI 0.105-0.279).The diagnostic odds ratio was 44.030 (95％ CI 27.964-69.325).And the AUC of sROC was 0.939.Conclusions IGRAs have a high sensitivity and specificity for the diagnosis of ITB,and specificity is consistent from study to study.IGRAs may be considered as a supplementary method in the differential diagnosis of ITB from CD.

Objective To evaluate the significance of detecting plasma methylated Septin9 (SEPT9) alone and combined with fecal immunochemical test (FIT) in screening colorectal cancer (CRC) and adenoma.Methods From October 2014 to April 2015,outpatients received CRC and adenoma screening were enrolled.Colonscopy examination and pathological diagnosis were taken as gold standard.The sensitivity and specificity of plasma methylated SEPT9 and FIT in CRC and adenoma were calculated.The diagnostic value of combined examination was evaluated.Receiver operating characteristic (ROC) curve of SEPT9 in CRC diagnosis was drawn.Results A total of 300 outpatients were enrolled.Among them,CRC was detected in 45 patients (15.0％) and adenoma was detected in 68(22.7％) patients,including 37(12.3％) cases of advanced adenomas.The sensitivity of SEPT9 and FIT for CRC diagnosis was 80.0％ and 88.9％,and the specificity was 95.3 ％ and 54.1％,respectively.The area under concentration curve (AUC) of methylated SEPT9 in CRC diagnosis was 0.923.The sensitivity of SEPT9 and FIT in advanced adenoma diagnosis were 10.8％ and 62.2％,and the specificity were 83.3％ and 49.0％,respectively.The sensitivity of combined examination in CRC diagnosis was 97.8％ and the specificity was 52.9％;the sensitivity in advanced adenoma diagnosis was 67.6％ and the specificity was 47.4％.Conclusions Plasma methylated SEPT9 is helpful in CRC screening,moreover,when combined with FIT,it can increase detection rate of colorectal adenoma.

Objective To further understand factors that influence health-related quality of life (HRQOL) in patients with ulcerative colitis (UC),especially the role of perceived stress and coping modes in Chinese patients with UC.Methods This study was a cross-sectional study.Patients with UC were recruited from July 2013 to September 2014 in Peking Union Medical College Hospital.HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ).Perceived stress was measured by Perceived Stress Scale (PSS).Coping strategy was evaluated using Medical Coping Modes Questionnaire (MCMQ).Demographic data,course of the disease,clinical disease activity,and disease phenotype according to Montreal classification were also collected.Univariate analyses were conducted to determine which variables were associated with HRQOL,and those were statistically significant were entered into a multivariate regression model.Results We recruited 214 patients (response rate 92.2％),whose median age was 37.5 (29.0,49.3) years old and median course of UC was 4 (2,9) years.Through univariate analyses,better HRQOL was significantly associated with regular medical visits,lower number of previous relapses and hospitalizations,no steroid use,Montreal E1,lower Mayo scores,clinical remission,less perceived stress and less acceptance strategy use.However,multivariate analyses revealed that perceived stress (OR =1.112,95％ CI 1.058-1.169),acceptance (OR =0.310,95％ CI 0.141-0.685),number of hospitalizations (OR =2.924,95 ％ CI 1.328-6.437) and clinical activity (OR =5.058,95 ％ CI 2.312-11.066) were most strongly related to HRQOL.Conclusions HRQOL of UC patients are not only associated with clinical activity of the disease,but also associated with coping strategy and perceivedstress.Further research needs to focus on whether or not relieving stress and guiding patients to cope with ulcerative colitis would improve HRQOL.

Objective To investigate the possible influence of immunosuppressive therapy,including sirolimus (SRL) and calcineurin inhibitors (CNI, tacrolimus), on level of Treg in the liver allo-graft recipients, Methods Forty-seven liver transplant recipients with stable liver function were assessed for at least 2 years, and divided into two groups: one composed of 15 patients receiving SRL,and another, of those receiving CNI (32 patients with tacrolimus). Thirty-eight age-matched healthy subjects (HS) were used as normal controls. We examined the expression of CD4, CD25, and Foxp3 in peripheral blood monouclear cells. Treg of every group was analyzed using Cell Quest software.Results SRL significantly increased the prevalence of CD4+ CD25high T cells, compared with HS and CNI group. The prevalence of CD4+ CD25high T cells of CNIs group was significantly lower than that of HS. The percentage of CD4+ CD25high T cells in the total CD4+ T cells was 1.88 % (1.56 %-2. 60 %), 1. 15 % (0. 57 %-l. 48 %) and 0. 84 % (0. 46 %-1. 45 %) in SRL, NS and CNI group,respectively (P<0. 01 or P<0. 05). Foxp3 was expressed in more than 95 % of CD4 + CD25high T cells and less than 20 % of CD4+ CD25low T cells, whereas not expressed in CD4+ CD25- T cells.Conclusion Different immunosuppressive therapy (SRL or CNI) might have different roles in tolerance induction in liver transplant recipients. Namely, SRL promoted the induction of allo-antigen tolerance, but CNI hampered the progression.