Objective To observe the dynamic change of serum levels of perioperative procalcitonin (PCT ) ,C-reactive protein (CRP) ,interleukin 6(IL-6) and N-terminal brain natriuretic peptide(NT-proBNP) in the patients with lung cancer and to evaluate their value in postoperative monitoring .Methods Seventy-two patients with lung cancer were detected PCT ,CRP ,IL-6 and NT-proBNP levels before operation and on postoperative 1-5 d .The detection results were compared between the patients with cardiac injury and infection complications .Results Postoperative levels of serum PCT ,CRP ,IL-6 and NT-proBNP were increased in all the patients ;the peak value appearance of PCT ,CRP ,IL-6 and NT-proBNP in the patients with complications were earlier than that in the patients without complications ,moreover the peak value was significantly higher than that in the patients without complications (P<0 .05);the decrease speed of PCT ,CRP ,IL-6 and NT-proBNP in the patients with complications was slower than that in the patients without complications .Conclusion The combined detection of PCT ,CRP ,IL-6 and NT-proBNP may be become an effec-tive means to differentiate the postoperative complications .

The clinical data of 8 patients with the fourth-degree laceration of perineum, who were admitted in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2004 to December 2010, were reviewed retrospectively. The causes and clinical strategies were analyzed. The fourth-degree laceration of perineum was mainly caused by improper skills of midwifery, too faster labor,insufficient estimation of fetal-weight and perineal condition and obstetric forceps in this group of patients.Primary suture was performed and all cases achieved complete healing. The improvement of midwifery skill,carefully monitoring the uterine contraction, accurate evaluation of condition of perineum and the fetal-weight and good communication between patients and midwives are the key points to prevent the fourth-degree laceration of perineum.

Objective To analyze the association of DOG1 protein with gastrointestinal stromal tumors(GIST). Methods Seventy-seven patients diagnosed with GIST between January 2005 and June 2010 were enrolled. The DOG1 expression in GIST was determined using immunohistochemistry.The result was compared with that of CD117 and CD34. Results Of 77 GIST patients, the DOG1 was expressed in 74 (96.10%) patients and CD117 in 70 (90. 9%) patients, with no significant difference between DOG1 and CD117 (P＞0.05). DOG1 expression was not related to the risk stratification of the tumor, site, age and gender (P＞0. 05). Of 7 GIST patients with negative CD117,6 patients were positive for DOG1 expression. Whereas 2 of 3 DOG1 negative patients were positive for CD117 expression. Conclusions DOG1, as a novel marker for GIST,has high sensitivity as CD117. It is a good complementarity in diagnosis of GIST when combine DOG1 with CD117, especially in diagnosis of CD117 negative patients. However, the DOG1 can not be used as an index in eveluating the risk stratification of the GIST.

BACKGROUND: It is believed that repetitive transcranial magnetic stimulation (rTMS) may produce such neurophysiological effects as regulating regional cerebral blood flow, neurotransmitters, local metabolism, and neuronal remodeling after nerve tissue injuries. The prognosis ofischemic stroke is related with the cortical function reconstruction in the ipsilateral and contralateral hemisphere of the lesion. Currently studies have not defined whether rTMS can affect the cortical function, protect ischemic neurons and promote motor functional recovery after cerebral ischemia.OBJECTIVE: To investigate the effects of rTMS on rat motor cortical excitability and neural function in acute stage of cerebral ischemia-reperfusion injury.DESIGN: Completely randomized experiment.SETTING: Electroneurophysiological Laboratory of Peking Union Medical College Hospital.MATERIALS: The experiment was completed in the Zoological Research Center of Peking Union Hospital from January to June 2004. Totally 22adult male healthy Wistar rats were randomly divided into treatment group and the control group with 11 in each.METHODS: After determination of the average motor threshold of the right hind limbs, which was 22% of the maximum output, the rats were subjected to middle cerebral artery occlusion for 1 hour followed by reperfusion for 72 hours. At each time point of immediately and at 12, 36 and 60 hours after the initiation of reperfusion, the rats in the treatment group received rTMS treatment (20 Hz, 40% maximum output, 5 seconds for each session with an between-session interval of 2 minutes for a total of 10 sessions), and the site for motor threshold evaluation was used for rTMS stimulation; the rats in the control group recevied no treatment after model establishment. Motor threshold testing was performed in both groups 4 hours after the last session of treatment to avoid immediate-early effects of rTMS on the motor threshold. At 24 and 72 hours of reperfusion, the scores of neural function were recorded according to evaluation systems. All the rats with scores between 1 and 3 were enrolled in statistical analysis were evaluated between.MAIN OUTCOME MEASURES: ① Motor threshold of the rats in both groups before and after injury; ② Neural function scores at 24 and 72 hour reperfusion; ③ Infarct volume at 72 hour of reperfusion.RESULTS: Totally 13 rats entered the final result analysis. Before injury,motor threshold in the treatment and control group was similar (P=0.71),and after the injury, the motor threshold of the control group was 1.49times that of the treatment group but such difference was not statistically significant [(41.62±24.73)% vs (28.00±9.35)%, t=-1.17, P=0.27]. At 24hours of reperfusion, the functional scores of the treatment group and control group were not significantly different (P=0.46), but at 72 hours, the scores of the treatment group were significantly lower than that of the control group (1.60±1.52 vs 7.75±3.62, t=-3.57, P=0.004). The average infarct volume of two groups was (62.00±60.88) mm3 and (20.00±12.41) mm3 at 72 hours of reperfusion, respectively, which, after logarithm transformation,was not significantly different between the two group (t=-1.31, P=0.22),but when the infarct volume was transformed into Log10 values, a significant difference occurred between them (P=0.045).CONCLUSION: rTMS may stabilize and prevent the increment of the motor threshold, time-dependently relieve the neural function disability and reduce the infarct volume after cerebral ischemia-reperfusion injury.

Objective To explore the effect of antinuclear antibody ( ANA+dsDNA),extractable nuclear antigen (ENA) and antineutrophil cytoplasmic antibody (ANCA) on the clinical manifestation and cerebrospinal fluid characteristics of neuromyelitis optica (NMO).Methods All 41 patients with NMO in PUMC hospital from 1985 to 2009 were retrospectively reviewed.All patients underwent examination of serum ANA+dsDNA,ENA and ANCA.Fourteen positive-autoantibody patients were compared with 27negative-autoantibody patients in gender,onset age,duration,relapse ratio,first demyelination event,the extent of optic neuritis and myelitis,EDSS,CSF protein,WBC,Oligoclonal band, 24 hours IgG index and myelin basic protein.Results The 14 NMO patients (34.1%) had positive non-organ-specific antibodies.NMO patients who had negative autoantibodies were compared with NMO patients with positive autoantibodies with significantly higher EDSS (the EDSS score were 4.5 and 2.5 respectively,U=92.5,P=0.008),more complete damage of spinal cord (3/14 vs 0/27, x2=6.736, P=0.0095) and tended to have higher visual Function Scale in remitting phase.There was no significant difference on the gender,onset age,duration,relapse ratio,first demyelination event.The positive-autoantibody patients had higher CSF WBC (2.0 vs 0,U=68.0,P=0.007) and tended to have lower 24 hours IgG index (-8.663 vs 0.163,U=30.0,P=0.053).There was no significant difference in CSF protein,MBP and OB.Conclusion NMO patients with positive autoantibodies have more severe intrathecal autoimmune inflammatory and disability,so they might need more intensive treatment.

Objective To study the relationship between intradialytic hypertension (IDH) and inflammatory factors in patients with maintenance hemodialysis.Methods Forty maintenance hemodialysis patients were involved,including 20 patients with IDH (IDH group) and 20 patients without IDH(non-IDH group) during hemodialysis.All of them had no sign of acute infections or other progressive disease.The levels of C-reactive protein (CRP),interleukin (IL)-1 β,IL-6,tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay (ELISA) before hemodialysis and 1,2,4 h after hemodialysis.The correlation of hypertension to CRP,IL-1 β,IL-6,TNF-α was analyzed.Results The levels of CRP,IL-1β,IL-6,TNF-α were increased in IDH group with the progress of hemodialysis,but were stable innon-IDH group.Logistic regression analysis indicated that there were positive correlations between CRP (r =0.3652),IL-1β (r =0.3261 ),IL-6(r =03156),TNF- α (r =0.3324) and blood pressure during hemodialysis (P ＜ 0.01 ).Conclusion The levels of CRP,IL-1β,TNF-α,IL-6 are positively related to the IDH in maintenance hemodialysis patients.

BACKGROUND:Previous studies have demonstrated that normal rat liver homogenate supernatant can induce human umbilical cord mesenchymal stem cels to differentiate into hepatocyte-like cels with partial hepatocyte functions. However, whether fibrotic liver homogenate supernatant can work or how the inducing effect is remains unclear. OBJECTIVE:To investigate the differentiation potential of human umbilical cord mesenchymal stem cels into hepatocytes under the normal liver and fibrotic liver microenvironment in vitro. METHODS:Liver fibrosis was induced in the SD rats by repeated intraperitoneal injections of 3% thioacetamide at a dose of 200 mg/kg body mass, twice a week for 4 weeks, and then fibrotic liver tissues and normal liver tissues were used to prepare liver homogenate supernatants. Passage 3 human umbilical cord mesenchymal stem cels were used and divided into standard control group (cels were cultured in DMEM/F12 with 10% fetal bovine serum), fibrotic liver homogenate supernatants group (cels were cultured in DMEM/F12 with 10% fetal bovine serum and 50 g/L fibrotic liver homogenate supernatants), normal liver homogenate supernatants group (cels were cultured in DMEM/F12 with 10% fetal bovine serum and 100 g/L normal liver homogenate supernatants). The morphological changes of the cels in each group were recorded under inverted microscope; the protein levels of CK18, AFP, CYP3A4, CYP2E1, CYP2D6 and TPH2 were evaluated using western blot assay. Furthermore, the concentration of albumin in the cels was measured. RESULTS AND CONCLUSION:After a 7-day inducement, the stem cels in liver homogenate supernatants groups lost their fusiform shape and changed into hepatocyte-like cels with the morphous of round shape. Compared with the standard control group, the hepatocyte-like cels in the two liver homogenate supernatants groups exhibited human hepatocyte biomarkers, CK18 and AFP. The standard control group cels could express a little amount of CYP2E1, while cels in the two liver homogenate supernatants groups could express CYP3A4, CYP2E1, CYP2D6, TPH2. Compared with the standard control group, the expression level of CYP2E1 in the two liver homogenate supernatants groups increased significantly (P < 0.01), and however, the relative levels of CYP3A4, CYP2E1, CYP2D6, TPH2 in the two liver homogenate supernatants groups showed no statistical significance (P > 0.05). At the same time, compared with the standard control group, the concentration of albumin in the two liver homogenate supernatants groups markedly increased (P < 0.01), but there was no difference between the two liver homogenate supernatants groups (P > 0.05). Experimental findings demonstrated that both of normal liver tissue and fibrotic liver tissue microenvironments could induce human umbilical cord mesenchymal stem cels to differentiate into hepatocyte-like cels. To achieve the same effect, compared with normal liver tissue, fibrotic liver tissue required lower concentrations, suggesting that fibrotic liver tissue microenvironment may be more conducive to differentiation of umbilical cord mesenchymal stem cels into hepatocytes.

Objective:To provide policy recommendations for Beijing public health departments to grasp the dy-namic allocation of healthcare resources and the advantage of medical functional dispersal, and making appropriate health policies to rationally adjust the allocation of health resources. Methods:To study the dynamic function of Bei-jing medical, this study uses the method of accounting of cases summary of the annual report on health finance through the descriptive analysis of the gross fixed capital formation in various regional government-run health facili-ties. Results:The results of this study show that the quality of medical health administrative resources was higher, but effectively dispersed in 2015. By contrast, the basic public health resources allocation was unbalanced. Conclu-sion:This study puts forward the corresponding health policy suggestions. On one hand, it is important to make fur-ther policy to encourage high quality medical resources to be effectively relieved and the regional planning should be done according to market demand by avoiding the blind construction at the early stages. On the other hand, much at-tention should be paid on the balanced development of the basic public health service ability and the coordinated de-velopment of administrative capacity in health, and supporting policies should be formulated, which should rationally allocate the public health resources for a better overall medical functional dispersal.

Objective To summarize the data of cosmetics dermatosis happened in Bering in 2006 and to analyze their characteristics of this side effect.Methors The outpatients in the Department of Dermatology.Air Force General Hospital from Jun.2006 to Dec.2006 were investigated and screened out the cosmetic dermatosis according to GB17149.1～7-1997,the patients'age,gender,job and the demographic data and the suspected cosmetics were recorded and analyzed,and the routine patch tests using the involved cosmetic products were carried out in each patient.Results 327 cases of cosmetic dermatosis were reported.Among all cases.98.47% of the patients were female,and most of them aged between 21 and 40 years old:The suspected cosmetics included 47 brands with 618 imposed products,43 brands with 293 domestic and the joint venture products,and 14 illegal products;Clinically,318 cases(97.24%)of the lesion were diagnosed as cosmetic contact dermatitis.7 acne and 2 skin discoloration.Conclusion Cosmetic contact dermatitis is the most common cosmetic dermatosis,and the young and middle-aged females with middle or high education are the most susceptible people to cosmetic dermatosis.

Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI<25 kg/m2 (normal weight group),the intra-opera-tive and postoperative indicators and surgical complications were compared between two groups.Results In obesity group,72(72.00%)patients had intra-operative blood loss of >60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration of surgery,and more bleeding are high risk factors for SSI in colorectal cancer patients.