Objective To explore the correlation between the depression status of patients with post-stroke depression(PSD) and nerve function defect.Methods 75 patients in the first 24h of acute stroke onset were selected.According to the Zung depression self rating scale(SDS),75 cases were divided into simple stroke patients group and PSD group,and the Hamilton depression scale (HAMD) and Scandinavian nerve function defect rating scale (SSS) were used for further evaluation.The score results were statistically analyzed.Results Of 75 cases with acute stroke,32 cases(42.7％) were diagnosed PSD.Admission day 2,at the end of 1,2 and 3 weeks,the HAMD scores between PSD patients and simple acute stroke group had statistically significant differences (all P ＜ 0.01).The HAMD scores of three groups of PSD patients (light,medium,heavy) appeared obvious changes with the prolonged time,which were significantly higher than the simple stroke group.The SSS score of simple stroke group and mild PSD patients increased with prolonged observation time,the difference between the two groups was significant (q =9.75,P ＜ 0.05).The SSS score of moderate and severe PSD patients decreased with prolonged observation time,compared with the simple stroke group,the differences were statistically significant(q =50.23,46.82,all P ＜ 0.05).In simple stroke patients and mild PSD patients,HAMD scores and SSS score had no correlation (r =0.062,P ＞ 0.05).In moderate and severe PSD patients,HAMD score and SSS score had correlation (r =4.682,P ＜ 0.05).Conclusion The incidence rate of PSD in acute brain stroke patients was 42.7％,and in patients with moderate and severe PSD,HAMD scores correlated with the degree of nerve function defect.Early intervention on depression treatment and promote the recovery of neural function is also important.

10mg/L(n=22) group,and CRP10mg/L group with CRP10mg/L group and the concentration of CRP inverse correlation with serum ALB,Fe,Hb levels.Conclusions The elevated concentration of CRP is considered to be the most common cause of decreased EPO or hyporesponsiveness to EPO in CRF anemia patients. CRP level can predict whether CRF anemia,dificult or easily degree of the anemia correction for CRF patients,all that provide evidence for improving CRF anemia.

ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.

Objective To improve the recognition of diagnosis, treatment and leukemia transformation of primary myelofibrosis (PMF). Methods One case with PMF which transformed into acute myeloid leukemia (AML) was reported and the literatures on this topic were reviewed. Results The patient was diagnosed according to the 2008 version of the WHO classification of PMF leukemia transformation was diagnosed after 2.5 years. The JAK2 V617F gene mutation was detectable both before and after leukemia transformation. The outcome of low dose chemotherapy could keep a short time. Conclusion JAK2 V617F gene could remain detectable after leukemia transformation in PMF patients. It is difficult to control the disease progress by low dose chemotherapy.

Objective:This study aimed to investigate the associations between single-nucleotide polymorphism (SNP) of IGF-1 and IGFBP-3 gene and risk of non-smoking female lung cancer in Chinese population. Methods:Genotyping was performed using the TaqMan method in 287 histologically confirmed non-smoking female lung cancer cases and 281 healthy controls. Results:The geno-type distributions of IGF-1 polymorphisms were significantly different between cases and controls (P<0.001). Analysis of multivariate logistic regression showed that the carriers of the CC genotype exhibited a significantly decreased risk of lung cancer in non-smoking female (adjusted OR=0.28, 95%CI:0.15-0.54). IGF-1 rs1520220 GG genotype may reduce the risk of advanced lung cancer incidence in nonsmoking female (adjusted OR=0.30, 95%CI:0.09-0.96). Log-rank test and Cox regression analyses revealed that variant geno-types of IGF-1 rs2946834 CT/TT had a significantly decreased lung cancer mortality risk compared with the homozygote CC in≥60 age group or patients with a lung tumor>3 cm. Conclusion:The IGF-1 polymorphism was associated with the risk of lung cancer and prognosis among non-smoking female. More rigorous laboratory studies of large sample population and functional studies are warrant-ed to confirm our findings.

Objective To analyze the mutations of FMS-like tyrosine kinase 3 internal tandem duplication (FLT3/ITD) in bone marrow cells of patients with newly-diagnosed acute myeloid leukemia (AML).Methods The mutations of FLT3/ITD in 96 AML cases were detected by polymerase chain reaction (PCR)and the clinical features of FLT3/ITD positive patients were analyzed.Results FLT3/ITD mutations were identified in 18 patients (18.8 ％),2 cases were M2,11 cases were M3,2 cases were M4,3 cases were Ms.Patients with FLT3/ITD mutations presented higher initial white blood cell count than that of patients without FLT3/ITD mutations [18.0×109/L (3.6×109-137.6×109/L) vs 6.3×109/L (4.5×109-113.0×109/L),t =3.04,P ＜ 0.05].Out of FLT3/ITD positive patients,13/16 (81.3 ％) obtained complete remission and 13 patients remained in first remission in a median follow-up of 10 months(6-15 months).Conclusion The mutations of FLT3/ITD are frequently identified in newly-diagnosed AML patients,patients with FLT3/ITD mutations present high white blood cell count.

Objective To investigate the distribution and antibiotic resistance of gram-negative bacilli for better antimicrobial therapy in our hospital.Methods A retrospective analysis was conducted for the 1 060 strains of gram-negative bacilli isolated from clinical specimens during 2013.Results Of the 1 060 gram-negative bacterial strains isolated during 2013,E.coli,K . pneumoniae,P .aeruginosa and A.baumannii were the leading pathogens,accounting for 29.3%,22.8%,11.5% and 9.9%,respectively.The prevalence of extended spectrum-lactamases (ESBLs)positive strains was 63.7%,32.2% and 28.0% in E.coli,K .pneumoniae and P .mirabilis,respectively.The Enterobacteriaceae strains were highly sensitive to carbapenems.The percentage of the P .aeruginosa isolates resistant to meropenem,imipenem or amikacin was lower than 30%.The percentage of the Acinetobacter spp.(A.baumannii accounted for 70.9%)strains resistant to meropenem and imipenem were 25.0% and 26.2%.Conclusions Most of the gram-negative bacilli are resistant to multiple antimicrobial agents. We should strengthen the monitoring of the antibiotic resistance of gram-negative bacilli and optimize antimicrobial therapy.

Objective To characterize the relationship between such phenotypes and the patterns of genetic mutations in the corresponding resistance genes in drug-resistant Mycobacterium tuberculosis (MTB)isolates in Shenzhen of China during 2007-2008.Methods According to standard of WHO,International Union Against Tuberculosis and Lung Disease(IUATLD),136 strains of MTB were collected by performing drug sensitivity test(DST)to isoniazid,rifampicin,streptomycin,ofloxacin and kanamycin on Lowenstein-Jensen in 1%proportion method.Genetic mutations in the corresponding resistance genes (rpoB,katG,rpsL,rrs1,gyrAB,rrs2)in these MTB isolates were identified by PCR,followed by DNA sequencing of the purified PCR products.The minimal inhibitory concentration(MIC)values of the aforementioned anti-tuberculosis drugs were determined for these MTB clinical isolates by two-fold dilution method in vitro.Results A total of 123 isolates were collected,73 isolates were drug resistant.50 isolates were drug susceptible.Among the isolates that were resistant to isoniazid,rifampicin,streptomycin.ofloxacin and kanamycin,the proportion of isolates that harboured mutations in the respective genes was 84.6%,93.6%,65.9%,100%,61.1%.For katG gene,the mutation detected were S315T or S315N.For rpoB,the most frequently found changes were S531L(30/44,68.2%)and H526D(9/44,20.5%)or H526R(1/44,2.3%).The reported mutations that K43R and KS8Q were founded in the rpsL locus and 491C→T and 513A→C were founded in the rrs1 gene related with streptomycin-resistant strains.For gyrA,all gyrA mutations were clustered in codons 90,91,and 94 apart from the S95T that was natural polymorphism.accounted for 81.1% of the ofloxacin-resistant isolates,and condon 91 was the most frequently mutated.No mutation were found in gyrB.The most frequent substitution were 1400 A→G(9/11,81.8%)and 1483 G→T(2/11,18.2%)in a specific region of the rrs2 gene related with kanamycin-resistant strains.No mutations except S95T of gyrA detected in the drug-susceptible isolates.The MIC values of clinical drug-resistant strains that the same drug-resistant group contains a different resistance phenotype are basically the same with the relevant resistance genes in the same mutation.Associated resistance mutations in different sites varied significantly with their MIC values.Conclusion The mutation characterization of drug-resistant and drug-suscep-tible isolates of MTB have been shown to vary according to geographic region,phenotypic characteristics exist difference in resistance levels due to different muntants of drug-resistant gene.

Objective To explore the value of lymphatic mapping (LM) and sentinel lymph node(SLN) analysis in laparoscopic colectomy for colon carcinoma. Methods Thirty-two patients with clinically localized colonic neoplasms were subjected to submucosal injection of isosulfan blue dye (0.5-1.0 mL) via a colonoscope during operation. Blue-stained lymphatics were visualized through the laparoscope and followed to the SLN,which was tagged. The colectomy was completed in standard fashion. All lymph nodes were stained by hematoxylin and eosin,and multiple sections of each SLN were examined by immunohistochemical (IHC) staining using cytokeratin antibody. Results At least one SLN was identified laparoscopically in all patients. The SLN accurately predicted the tumor status of the nodal basin in 94% of cases. In 8 cases (25%),an unexpected lymphatic drainage pattern altered the extent of mesenteric resection. The SLN was negative by HE staining in 4 (13%) cases,which were demonstrated positive for micrometastases through immunohistochemical staining. Conclusions SLN mapping during laparoscopic colon resection can alter the margins of resection and in combination with immunohistochemical staining may improve staging,which may more accurately assign patients to prospective protocols.

Objective To kown X-ray and clinic feature of thoracic metastasis of primary malignant tumor of female genital organs,so that to improve diagnostic accuracy.Methods All 204 cases of female genital tumor were confirmed by operation and pathology.The thoracic films of postero-anterior and lateral projections were performed before and after operation and chemotherapy in all patients, CT scan was performed in 30 cases CA-125 in 48 cases and HCG in 23 cases were done.All data of patients were reviewed and analysed by 3 doctors.Results 25 cases presented pleural fluid,CA-125 rised to 125-3765 u/ml;12 cases presented pulmonal shadow,hCG rised to 92-200000 mIU/ml.One of Choriocarcinoma had appeared pulmonal metastasis in normal pregnancy.Conclusion The metastasis of pleural fluid is most seen in ovary carcinoma,pulmonary metastatic tubercle is most manifestion in choriocarcinoma.Pulmonary metastasis of choriocarcinoma can't be ignored in normal pregnancy.