Objective To evaluate the feasibility of the serum galactomannan (GM) assay as a rapid detection method for the early diagnosis of invasive fungal infections (IFI) in haematological malignancy patients. Methods Thirty-nine patients with haematological malignancies at high risk of IFI were enrolled into this study. The criteria of high risk included fever (≥ 38℃) lasted for more than 96 hours, fever didn' t response to proper broad spectrum antibiotic or recurrenced after short period of response, and no antifungal drug was used in the last week. The GM assay in serum specimens were performed twice a week for 3 weeks. Thirty health donor were selected as control group to perform the serum GM assay. The sensitivity and specificity, the positive and negative predictive value (PV+, PV-) of GM assay in serum specimens were calculated and compared with traditional diagnosis methods. Results In the 39 patients, 31 patients were diagnosed as IFI by clinical evidence and the other 8 patients were diagnosed as bacteria infection. The cut-off of GM assay was 0.5. GM assay results showed that the positive rate, sensitivity, specificity, total consistent rate, PV+ and PV- were 80.6 %, 87.1%, 62.5%, 82.0%, 90.0 % and 55.6%, respectively. The Kappa rate was 0.474. In the 8 patients without IFI, 3 cases were GM positive and 2 BG positive. The time of the first positive GM assay was (2.8±4.8) d (ranged from 24 d before to 3 d after clinical diagnosis) before IFI was diagnosed. During antifungal treatment, the level of GM maintained highly in the patients with aggravation of IFI, and dropped with the IFI improving. Conclusion The results of GM assay were consistent with that of traditional IFI diagnosis. Compared with classical IFI diagnosis, the GM assay has the advantages of the early, rapid, and high sensitivity and specificity.

Objective:To develop a safety protection device for lead cable of equipment in order to reduce or avoid the skin burn of patient and the invalidation of monitoring data caused by the short circuited of lead cable, and enhance the comfortable level of patient, at the same time, and reduce the pain of patient and potential adverse events.Methods: The device was consisted of the fixed sleeve of cylinder-shape (protective shell) and fixed sleeve of packaged cable (fixed sleeve of wire and cable), and its component was carbon fiber reinforced polycarbonate and silicone rubber. The fragile, repaired part or the rupture rubber of shell in upside and bottom of device were clamped in fixed sleeve. And then, the upside and bottom were fixed in one device, and take them socket with lead cable of device.Results: After the safety protection device of leading cable were used, the cable were fixed in the interior of the device, and could be protected. Therefore, some risks of adverse event were reduced and avoided.Conclusion: The device is stable in performance, is simple and convenient in operation and installation. In the application, it avoids the risk which caused by short circuit of cable in therapy monitoring, and could enhance the comfortable feel. This device is appropriate to various installation and application of lead cable, and it can be repeated to apply. It has got national patent for utility models due to its favourable application value.

Objective To analyze the features of hidden blood loss in the elderly femoral intertrochanteric fractures treated with extramedullary dynamic hip screw (DHS), intramedullary nails (Gamma 3, PFN) and hip arthroplasty (LBFH). Methods The clinicle records of 193 elderly patients (ages ≥75 year old) with femoral intertrochanteric fractures treat by DHS,Gamma3, PFNA and LBFH in our hospital were retrospectively analyzed. The estimated blood loss were calculated by Gross equation, according to the height,weight and changes of blood routine test reoperative and postoperative,the differences of hidden blood loss among DHS group,Gamma 3 group, PFN group and LBFH group were compared. Results Total blood loss in intramedullary nail groups were significantly higher than DHS group [(766 ± 83) mL],P < 0.05). No significant difference was found between PFN group [(887 ± 75) mL] and Gamma 3 group [(903 ± 91) mL] (P > 0.05), The hidden blood loss were significantly higher in the intramedullary nail groups than those in the LBFH group [(453 ± 98) mL,accounting 54%] and DHS group [(429 ± 59) mL,accounting 56%] (P < 0.05). No significant difference of hidden blood loss was found between Gamma 3 group [(742 ± 137) mL, accounting 82%] and PFN group [(711 ± 153) mL,accounting 80%], (P > 0.05). Conclusion Noteworthy, the hidden blood loss is major part of perioperative total blood loss in the elderly femoral intertrochanteric fractures , intramedullary fixations may result in greater hidden blood loss than extramedullary fixations and hip arthroplasty ,which may cause postoperative anemia.

Objective To investigate the influence of gonadotropin releasing hormone agonist (GnRH-a) on the expression mRNA of nerve growth factor (NGF) and its receptors (TrkA and P75NTR) in normal and eutopic endometrial stromal cells (ESC).Methods From January to April 2009,3 patients with endometriosis undergoing surgery in Peking Union Medical College Hospital were obtained eutopic endometrium as study group matched with eutopic endometrium from 3 parents with teratoma as control group.ESC were incubated with different concentration of GnRH-a (0,5 × 10-11,5 × 10-10,5 × 10-9,5 ×10-8,5 × 10-7 g/ml).The expression of mRNA of NGF,TrkA and P75NTR were measured by real-time-PCR.Results At concentration of 0 g/ml,the levels of NGF,TrkA and P75NTR mRNA in ESC were 6.32,8.55,8.08 in study group,which were significantly higher than 0.94,0.67,1.08 in control group (P ＜0.05).Treated by the following concentration of GnRH-a (5 × 10-11,5 × 10-10,5 × 10-9,5 × 10-8,5 ×10-7 g/ml),the median expression of NGF,TrkA and P75NTR mRNA was 1.00,0.96,1.05; 1.09,0.82,1.27 ; 1.04,0.52,0.81 ; 1.00,0.55,0.64; 0.78,0.49,1.02 in study group.Compared with the expressions of those untreated by GnRH-a in study group, they showed significantly lower trends (P ＜0.05).In control group,the median expression of NGF,TrkA and P75NTR mRNA was 0.98,0.37,0.92; 0.70,0.45,1.15; 1.55,0.80,1.35; 1.09,0.41,1.35; 0.90,0.82,1.18.Compared with the expressions of those untreated by GnRH-a in control group,there were no statistically differences ( P ＞0.05).And treated by the same concentration of GnRH-a,the expressions of NGF,TrkA and P75NTR mRNA did not show statistically difference between the two groups ( P ＞ 0.05 ).Conclusion The expression of NGF.TrkA and P75NTR mRNA were suppressed by GnRH-a.

Objective To evaluate the clinical value of 3D-FS-SPGR and 3D-reconstructional technique in detecting the lesion of articular cartilage of knee.Methods Fifty eight knees with OA(42 cases)or trauma (9 cases) in 54 cases (12 cases were confirmed by operation) were imaged with eight different MR imaging sequences including T 1-weighted,proton density-weighted,T 2-weighted FSE,STIR,3D-FS-SPGR,2D-FS-SPGR,3D-SPGR and 3D-FS-GRE.The classification and three-dimensional reconstruction of cartilage in four locations of knee were performed on different MR sequences.The detecting rate of cartilage lesion were calculated.The results in partly cases were analysed compared to operation. Results The detecting rate was different on each sequence as follow:T 1WI,GRE,STIR,PDWI,T 2WI and SPGR were 8.91%,16.36%,19.32%,19.57%,21.36% and 24.09% respectively (? 2=23.523,?

Objective To study the causes and management of biliary complications after orthotopic liver transplantation.MethodsClinical data of 38 patients who have underwent orthotopic liver transplantation between May 2000 and January 2002 were studied retrospectively. ResultsPostoperative bililary complications occurred in 9 patients(24%), including simple biliary fistula in 4, stricture of hepatoenterostomy, intrahepatic cholelith, biliary stricture with sludge, biliary stricture with cholelith, and intrahepatic biloma and cholelith in one each. Two patients died of the complication, and seven were cured successfully. ConclusionsThe causes of biliary complications are complicated. Early diagnosis and timely management helps to decrease the mortality. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography is a valuable, less traumatic procedure.

Objective To understand the contents of residual chlorine in the wastewater of 12 hospitals in the urban districts of Jinan. Methods Wastewater samples discharged from 12 hospitals were collected from June to September in 2003. The contents of residual chlorine in the wastewater samples were determined using iodometric titration method and the fecal coliform counts of the wastewater were determined. Results The contents of residual chlorine in the wastewater of 12 hospitals were 3.7 mg/L-128 mg/L with the average level of 27.6 mg/L. The result of the fecal coliform count in the wastewater was accorded with the National Hygienic Standard. Conclusion The contents of residual chlorine in the wastewater discharged from municipal hospitals in Jinan were too high, which might cause the secondary pollution to water environment.

The medical education of China and the United States was compared by analyzing the differences about educational system, teaching mode and teaching content in this paper. Standard-ization of the Chinese medical education system, improving clinical practice, teaching students by initi-ating questions and advanced medical education technology were recommended in China. This paper will inspirit and provide experience for the innovation of Chinese medical education.

Objective To study the electrophysiological characteristics of early-differentiated neural stem cells(NSC)in embryonic rats.Methods NSC were isolated from hippocampus of embryonic rats and cultured.The cells were plated onto poly-llysine hydrochloride glass cover-slips for 1 h or differentiated for 1-3 d in a differentiation medium.Whole cell patch-clamp technique was used to record the voltage-gated ion channel current.Results No inward Na+ current was detected in any undifferentiated NSC.One day after induction of differentiation,the cells exhibited a voltage-gated Na+ current,but could not induce an action potential.Two types of outward K+ current(delayed rectifier K+ and transient K+ current) and inward T-type Ca2+ current were detected in NSC and early-differentiated NSC.Conclusion The functional expression of Na+ current is a marker of early differentiation of NSC following cell cycle exit.Early differentiation of NSC is an important development stage of their ion channels.

0.05), while clinical control rate of the treatment group was better than the control group (P