Objective To investigate the relationship between serum soluble B7-H4(sB7-H4) expression and clinical pathological characteristics in patients with non small cell lung cancer(NSCLC),and its clinical significance.Methods 65 patients with NSCLC were selected as NSCLC group,58 patients with benign lung disease were selected as the benign lung disease group,another 45 healthy people of the same period in our hospital outpatient physical examination were selected as healthy control group.By enzyme-linked immunosorbent assay(ELISA) method,serum sB7-H4 and vascular endothelial growth factor(VEGF) were detected.The serum embryonic antigen(CEA) and cancer antigen-125(CA125) were detected by chemiluminescence method.The relationship between sB7-H4 and NSCLC and other pathological features,and the relationship of the tumor markers CEA,CA125,VEGF were analyzed.Results The level of serum sB7-H4 of the NSCLC group was (59.47±8.76)μg/L,which was significantly higher than (17.38±3.72)μg/L of the lung benign lesion group and (15.26±3.17)μg/L of the health control group,the differences were statistically significant(t=18.276,19.872,all P<0.01).The serum CEA,CA125,VEGF levels of the NSCLC group were higher than those of the lung benign lesion group and healthy control group,the differences were statistically significant(t=9.447,14.883,33.467;t=11.374,15.137,37.759,all P<0.01).The level of serum sB7-H4 of the NSCLC group after treatment was (35.47±7.46)μg/L,the difference was statistically significant compared with before treatment[(59.47±8.76)μg/L](t=4.372,P<0.01).The serum sB7-H4 level was correlated with NSCLC tissue differentiation degree,clinical stage,whether with lymph node metastasis (F=3.786,t=4.821,4.172,all P<0.01).In NSCLC patients,sB7-H4 level was positively correlated with serum CEA,CA125 and VEGF levels (r=0.643,0.727,0.586,all P<0.05).Conclusion The sB7-H4 may be involved in the occurrence and development of NSCLC,and it is expected to become a new target for NSCLC diagnosis and treatment.

Objective:To investigate the relationship of urinary 8-oxoguanosine(8-oxoGsn)with muscle mass, muscle strength, advanced glycation end products(AGEs), trace elements, heavy metals and other health-related indictors in different age groups of the Beijing area.Methods:A cross-sectional research was conducted.Healthy adults aged 25 to 93 years who sought health examination in the Health Examination Center of Beijing Hospital were recruited.Participants were divided into the young and middle-aged group and the elderly group with age 60 as the cutoff.Urinary 8-oxoGsn levels were detected by mass spectrometry and adjusted using urine creatinine values.Body composition was measured by multifrequency bioelectrical impedance analysis(BIA). Grip strength, 6-meter walking speed and 5-times sit to stand test were conducted by experienced team members.Skin autofluorescence was used to detect skin AGEs.A portable optical scanner was used to detect heavy metals and trace elements using reference points of the palm.Levels of fasting blood glucose, glycosylated hemoglobin, high-density lipoprotein and other common blood biochemical indicators were measured.Results:A total of 106 subjects were enrolled, including 68 in the young and middle-aged group and 38 in the elderly group.The proportion of patients with hypertension(14 ases or 36.8% vs.7 ases or 10.3%), systolic blood pressure[130(120, 140) vs.120(110, 126)mmHg], fasting blood glucose[5.7(5.2, 5.9)mmol/L vs.5.2(4.9, 5.5)mmol/L], glycosylated hemoglobin[6.0(5.7, 6.2)% vs.5.7(5.4, 5.9)%], 8-oxoGsn/Cre[1.9(1.4, 2.6) vs.1.3(1.0, 1.6)], AGEs(2.44±0.46 vs.2.01±0.29), 5-times sit to stand test scores[7.8(6.9, 9.8)s vs.6.0(5.0, 6.8)s], magnesium(31.4±7.2 vs.27.7±6.4), mercury(0.013±0.003 vs.0.008±0.003)and silver[0.011(0.010, 0.012) vs.0.010(0.009, 0.011)]were higher in the elderly group than in the young and middle-aged group, while grip strength[28.0(22.0, 35.1)kg vs.36.6(28.5, 49.1)kg], fat-free mass[44.9(37.5, 51.1)kg vs.53.3(42.4, 58.5)kg], trunk muscle mass[21.0(17.5, 23.9)kg vs.25(19.8, 27.4)kg], appendicular skeletal muscle mass[20.9(17.6, 23.9)kg vs.24.9(19.8, 27.3)kg], calcium[273.3(219.1, 480.0) vs.457.8(428.5, 489.1)], cobalt[0.029(0.027, 0.031) vs.0.031(0.028, 0.034)], selenium[1.44(0.93, 1.71) vs.1.61(1.53, 1.68)]and nickel[3.5(3.3, 4.0)*10 -3vs.3.8(3.6, 4.1)*10 -3]were lower in the elderly group than in the young and middle-aged group( P<0.05). Urinary 8-oxoGsn/Cre levels were positively correlated with age, time of 5-times sit to stand test, AGEs, fasting blood glucose, mercury and aluminum( rs=0.443, 0.292, 0.357, 0.205, 0.316 and 0.214, P<0.05), and negatively correlated with trunk muscle mass, appendicular skeletal muscle mass, fat-free mass, grip strength, silicon and manganese( rs=-0.334, -0.333, -0.332, -0.366, -0.246 and -0.234, P<0.05), with statistical significance. Conclusions:Increased urinary 8-oxoGsn/Cre levels are correlated with decreased muscle mass, poor physical function, accumulation of AGEs, decreased trace element levels and increased heavy metal levels.Therefore, 8-oxoGsn has the potential to be a broadly representative and sensitive indicator for health assessment.

Objective To discuss the prostate biopsy results in young men with age less than 50 years and with PSA 4-10 μg/L.Methods From January 2006 to December 2011,22 patients with PSA 4-10 μg/L underwent prostate biopsy for free/total PSA ≤ 0.16 (20 cases) and/or positive digital rectal examination (DRE) (4 cases).The nean age was 43 years (range,24-49 years),the mean PSA level was 7.08 μg/L (range,4.17-9.74 μg/L),the mean free/total PSA level was 0.11 (range,0.03-0.53).Radiologic suspicious lesion was founded in 13 cases.Clinicopathological data from these patients were reviewed.Results The results of the biopsy were 1 (4.5％) case of prostate cancer,2 cases (9.1％) with tuberculosis,9 cases (40.9％) with inflammation,10 cases (45.5％) with benign tissue.In 20 cases with free/total PSA ≤0.16,only 1 case was diagnosed as prostate cancer.In 4 cases with positive DRE,tuberculosis (2 cases) and inflammation (1 case) were diagnosed.Conclusions The prostate cancer detection was rare in young men less than 50 years of age with PSA 4-10 μg/L.The most common cause was prostate hyperplasia with inflammation.

Objective To analyze current situation and development tendency of medical teaching case library construction and to provide information for medical teaching reform. Methods Bibliometrics was used to retrieve and analyze literatures on the subject of medical teaching case library construction from China National Knowledge Infrastructure, CBMdisc, VIP and Wanfang Data from construction to June 20th,2017. Results Totally 116 articles published in 71 journals were included.A gradual growth was found in the number of publication and funded articles. The average citation count was 2.05. A majority of articles were produced in Beijing, Guangdong and Shanghai. Medical teaching case library covered 9 majors and 42 courses and applied in class teaching (50.00%, 58/116), clinical practice (37.07%, 43/116), refresher training (2.59%, 3/116), assessment and evaluation (0.86%, 1/116). Satisfaction investigate,examination score analysis and expert review were commonly used to evaluate the quality of case library. Conclusions Researches in China on medical teaching case library construction were increasing in recent years.Case library were applied in various aspects of medical teaching,however, there still remained some problems.Articles on the subject of case library were not highly-cited.There was no core author group yet. The subject on medical case library still needed deep and further exploration. There′s suggestion that we should attach importance to medical case library construction and related study to push medical education reform.

Objective: To assess the diagnostic rate, safety and clinical application of percutaneous renal masses biopsy for advanced renal cell carcinoma patients.Methods: In this retrospective study, we collected the data of renal masses from the patients who underwent renal masses biopsy under ultrasound from April 2001 to December 2014 in Peking University First Hospital.A total of 75 patients who were undiagnosed or diagnosed with advanced renal cell carcinoma by the imageological method were enrolled in this study.The patient and lesion characteristics such as tumor size, pathology of tumor, histologic subtype, pathological grade, biopsied location and biopsied cores were recorded and analyzed.Results: Among all the 75 patients, biopsy was diagnostic in 64 cases (85.3%) and non-diagnostic in 11 cases (14.7%).Of the 64 diagnostic biopsies, 60 were malignant, including 37 (61.7%) renal cell carcinoma (RCC), 13 (21.7%) urothelial carcinoma and 10 (16.7%) other malignant masses.Of all the RCC subjects, 24 suffered from clear cell RCC, 5 papillary RCC, 3 collecting duct carcinomas, 1 unclassified RCC and 4 unknown subtypes.The 11 non-diagnostic biopsied samplings included inflammatory, blood and extrarenal tissue and normal renal tissue.The proportion of collecting duct carcinoma in RCC was 10.8% and the proportion of squamous carcinoma in urothelial carcinoma was 23.1%, which were both higher than the previous research findings.For the male and female groups, non-diagnostic yields were 6.5% and 30.4%, respectively (P=0.022).Of all the 75 patients, 13 renal cell carcinoma patients underwent the surgical treatment and got the results of postoperative pathology.Comparing preoperative biopsy pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rates for benign and malignant lesions, pathological subtype and pathological grade were 100%, 81.8% and 60%, respectively.Mild macroscopic hematuria occurred in 1 case after RMB and there were no serious complications in all the cases.Conclusion: Percutaneous renal masses biopsy under ultrasound with a high diagnostic rate which can define the histologic subtype of renal cell carcinoma.With targeted therapy, more and more patients whose evaluation suggests local advanced disease or metastatic tumors adopt renal tumor biopsy to define the histologic subtype, which could avoid unnecessary surgical treatment.