OBJECTIVE To investigate the pre-operation and/or pre-transfusion testing on patients to avoid risk of(occupational) infection exposure among medical staff and its significance in prevention of nosocomial infection.METHODS Serum hepatitis B(virus surface) antigen(HBsAg),antibody against hepatitis C virus(anti-HCV),(antibody) against human(immunodeficiency) virus(anti-HIV) and toluidine red unheatedserum test(TRUST) were performed on samples from 10 745 cases of pre-operation and/or pre-transfusion from 2003 to 2004.RESULTS The number and(percentage) of positive reaction for HBsAg,anti-HCV,anti-HIV and TRUST were 1163,(10.81%);21,0.20%;1,0.01%(confirmed by HIV Reference Laboratory,Center for Disease Prevention and(Control) of Zhejiang Province) and 74,(0.69%),respectively.TRUST positivity was further confirmed with TPHA.(Overlapping) infections were mostly observed between HBV and HCV,or,to a less scale,between HBV and syphilis.For HBV infection the(department) of digestive medicine was prevalent(?~2=4.77,P

Objective To comparisom five methods of detection of eosinophil cells,in order to analyze the precision of the five methods.Methods The eosinophil cells of 100 patients were tested by using microscope、BC T5difft and flow cytometry are(0.249 ±0.112) × 109/L,(0.253 ±0.105) × 109/L,(0.252 ±0.103) × 109/L,(0.256 ±0.104) × 109/L and(0.259 ±0.101) × 109/L.There are no statistical differences(F = 1.225,P＞0.10)among the five methods.Conclusion The results of the five methods are all accurate;the automatic analyzer method and the flow cytometry method are simple and repeatable,but the equipment and reagents are more expensive;the microscope direct counting method is more complicated and less repeatable.

To summarize the clinical data of two cases with severe hyponatremia diagnosed as adrenal insuffiency combined with syndrome of inappropriate secret on of antidiuretic hormone(SIADH),and to review related literatures.Case 1 diagnosed as Addison's disease for 27 years and developed severe hyponatremia again but did not response well to sufficient glucocorticoid.Further examination showed SIADH caused by lung cancer and tolvaptan worked well.Case 2 was diagnosed as SIADH caused by lung cancer and responsed well to tolvaptan.However,hyponatremia reoccurred with the decreasing level of ACTH and cortisol during the chemotherapy.It was thought that hyponatremia was caused by drug-related adrenal insuffiency and glucocorticoid replacement therapy achieved good response.Both primary/secondary adrenal insuffiency and SIADH can lead to severe hyponatremia,but it is rare that the two situations exist in one patient and occur in different time.We should consider the possibility of the situations when we make differential diagnosis of refractory hyponatremia,monitoring the curative effects carefully,then correct the diagnosis timely,and reduce missed diagnosis and misdiagnosis.

Diabetes insipidus ( DI) could lead to urinary tract dilatation, even renal dysfunction. This study compared clinical features of DI with or without urinary tract dilatation. The results showed that the former had earlier onset age, more male patients, longer duration, and higher serum creatinine, as well as lower urine osmotic pressure and urine specific gravity after injection of vasopressin. But only disease duration was the independent risk factor (OR=1. 248). More nephrogenic DI and more hereditary DI were with urinary tract dilatation compared with central DI or acquired DI.

Objective To investigate the clinical value of observing the differences of GSK‐3βprotein expression and activity lev‐el in the peripheral blood mononuclear cells between type 2 diabetes mellitus patients and healthy people .Methods Using ELISA to detect the GSK‐3βprotein expression and activity levels of people who contained 30 patients with type 2 diabetes whose blood glu‐cose were not controlled (test group 1) ,30 cases of patients with type 2 diabetes whose blood glucose were controlled (test group 2) and 30 cases of healthy human and all the data were analyzed .Results The GSK‐3βprotein content of Type 2 diabetes mellitus group was higher than the control group(P<0 .05) ,the activity level of GSK‐3βin test group 1 was higher than the control group and test group(P<0 .05) .The GSK‐3β protein content of test group 2 was higher than the control group(P< 0 .05) .The male GSK‐3βactivity level in the test group 1 was higher than the men′s in the control group(P<0 .05) .Conclusion The GSK‐3βprotein content has a high expression in the type 2 diabetes mellitus patients .After drug treatment ,the patients ,who have controlled the blood glu‐cose effectively ,still showes high expression of the GSK‐3βprotein content ,but the activity levels showes a significant decline .In male pa‐tients with type 2 diabetes blood sugar in the control group of GSK‐3βshowes significantly higher activity level .

Adrenal hemangioma is a rare neoplasm.The clinical data of a case of adrenal cavernous hemangioma and review of related literatures are herewith presented.Adrenal cavernous hemangioma is often nonfunctioning and benign.CT and MRI show the features of hemangioma.The treatment depends on the size of the mass,and the diagnosis is based on pathology.

AIM: To observe the different changes of neuroendocrine systems between the state of sport fatigue and poverty of movement. METHODS: 60 male Wistar rats were randomly divided into three groups: normal control group, sport fatigue model group and poverty of movement model group (20 rats in each group). The sport fatigue model was established by the method of combining basal diet and loaded swimming during 2 weeks, whereas the method of restricted activities was used to establish the poverty of movement model with total experimental time of 10 weeks. By the end of experiment, the climbing pole time was determined. The contents of hypothalamus thyrotropin releasing hormone (TRH), and serum norepinephrine (NE) and epinephrine (E) in rats with different treatments were determined by ELISA. In addition, the changes of hypothalamus corticotropin release hormone (CRH), pituitary adrenocorticotropic hormone (ACTH) and thyroid stimulating hormone (TSH), and serum corticosterone (CORT), triiodothyronine (T_3), tetraiodothyronine (T_4) were determined by radioimmunoassay to evaluate the functions of adrenergic nerve-adrenomedullin system, hypothalamo-pituitary-adrenal (HPA) axis and hypothalamo-pituitary-thyroid (HPT) axis. RESULTS: Compared to control group, the climbing pole time of the animals was obviously decreased in two model group. The adrenergic nerve-adrenomedullin system and HPA axis were inhibited in sport fatigue model rats, but HPT axis was unchanged. Interestingly, the HPA axis was hyperfunctional and HPT axis was inhibited in poverty of movement model rats. However, no change in the adrenergic nerve-adrenomedullin system was observed. CONCLUSION: Sport fatigue and poverty of movement all affect neuroendocrine system and lead to the adjustment mechanism imbalance, but the target and tendency are different.

ObjectiveTo evaluate the efficacy of stereotactic body radiotherapy combined with coinstan taneous gemcitabine,and gemcitabine alone for advanced pancreatic cancer.Methods56 advanced pancreatic cancer patients were assigned into observation group,which accepted stereotactic body radiotherapy combined with coinstantaneous gemcitabine 500 mg/m2,d1,d8.Other 50 patients were assigned into the control group which only accepted gemcitabine 1 000 mg/m2,d1,d8,d15.Stereotactic body radiotherapy was delivered with a total dose of 4 000-4 500 cGy in 10 fractions.ResultsCT examinations were carried out 2 months after treatment.The response rate of the observation group and control group was 82％ and 16％ respectively,and the pain relief rate was 67％ and 17％ respectively.The time to progression of the observation group was 14 months,and was better than that of the control group(7.5 months,x2 =7.31,P =0.032).The median survival time of the observation group and control group was 15.8 months and 13.2 months,and the difference had no statistical significance(x2 =3.28,P =0.082).ConcolusionStereotactic body radiotherapy combined with gemcitabine has a better overall response rate and a pain relief rate.It can prolong the time to progression,but can't improve the overall survival.

ObjectiveTo evaluate the alternations of left ventricular (LV) torsion of myocardial ischemia before and after reperfusion using speckle tracking imaging (STI).MethodsFourteen open-chest pigs underwent randomizedly 1 minute (group A) or 15 minutes (group B) of left anterior descending (LAD) ligation and followed up for 1 week.Torsion of LV in both groups were quantified by STI before LAD occlusion,LAD occlusion immediately,and 1-,5-,30-,60-,90-minute and 1-week after reperfusion.ResultsOne minute after reflow,decreased peak apical rotation and peak LV torsion fully recovered in the inner layer in group A.In contrast,there was a brief resumption in group B during 30min after reflow from (6.5 ± 0.8)° to (3.4 ± 1.2)°( P ＜0.01 ) and from (7.8 ± 1.0)° to (6.1 ± 1.1 ) ° ( P ＜0.01 ),respectively.Peak LV subepicardial torsion increased gradually after reperfusion.Conclusions As a result of various durations of ischemia,peak torsion in subendocardium and subepicardium change differently before and after reflow.STI may be suitable for evaluation of the extent of ischemia by noninvasive quantification of torsion in subendocardium and subepicardium.Therefore,duration of assessment of myocardial ischemia can be prolonged.

Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.