Objective To explore the expression of PTEN,NF-KB p65 and Survivin protein and the influence in the genesis and development of endometrial carcinoma(EC).Methods The expression of PTEN.NF-KB and Survivin in 63 cases of EC and 20 cases normal endometrial tissue specimens were detected by immunohistochemistry.Resuits There were obvious differences among the positive rates of PTEN.N-KB p65 and Survivin protein in EC compared with in normal endometrial tissue specimens (P＜0.001).The clinicopathological characteristics of endometrial carcinoma with PTEN,NF-KB p65 and Survivin were as follows:the expression of PTEN gene was positively correlated with the degree of histological differentiation(P＜0.001),and it was negatively correlated with lymph node metastasis and TNM (P＜0.005).There was inverse correlation between the expression of NF-KB p65 gene and the degree of histological differentiation(P＜0.05).It was positively correlated with lymph node metastasis,deep myometrial invasion and TNM in EC (P＜0.05).The expression of Survivin was positively correlated with the clinical stage and lymph node metastasis and deep myometrial invasion in EC(P＜0.05).Conclusion There are difierent extent action of PTEN.NF-KB p65 and Survivin significantly in genesis and development of EC.Detection of PrEN combined with NF-KB p65 and Survivin is valuable for early diagnosing and evaluating malignancy extent of EC.

Objective To investigate the streptomycin(SM)-resistance of Mycobacterium tuberculosis (MTB) in urine and to examine their relationships with the mutation of rspL gene. Methods 47 strains of MTB were isolated from the urine of patients with renal tuberculosis.The mutation of rspL gene were analyzed by PCR-SSCP with silver-staining,and the strains were tested for the sensitivity to streptomycin. Results All the 47 strains had positive expression of rspL gene of MTB,with 28 SM-resistant and 19 SM-sensitive.Among the 28 SM-resistence strains 19(68%) had rspL gene mutation by SSCP testing.The 19 strains of SM-sensitive had no mutation. Conclusions Detecting mutation of MTB rspL gene in urine by PCR-SSCP can rapidly and exactly identify the MTB's sensitivity to streptomycin,which is significantly important in clinical treatment of anti-tuberculosis.

Objective To study the application of total intravenous anesthesia(TIVA) in patients with larp-aroscopic cholecystectomy(LC). Methods 100 cases with LC were randomly and evenly assigned to two groups: the combined intravenous with inhalation anesthesia(CIIA) group(n = 50) and the TIVA group(n = 50). The maintain anesthesia. BP, HR and SpO2 at all stages and time for extubation,the consciousness were recorded. Results The pneumoperitoneum after 10 min HR(96.8±13.5)times/min,SBP(142.5±14.3) mmHg、DBP(93.0±14.3) mm-Hg in A group higher than before induction of anesthesia(82.3±12.5) times/min, (129.0±21.7) mmHg, (77.3±13.5) mmHg(P < 0.05～0.01) ; The pneumoperitoneum after 10 min HR (84.0±11.0) times/min, pneumoperito-neum comphte(76.3±9.0) times/rain in B group lower than the(96.8±13.5) times/min, (84.1±11.0) times/min in A group(P >0.05); B group patients completed the opening time(6.5±1.5) min、extubation time (11.5±1.4) min、pestoperative nausea and vomiting in 3 cases,after 8 h VAS value of (2.8±1.1) in group B were lower than the (10.5±2.8) min,(25.2±9.5)min,12 cases(5.4±2.1) in group A(t =2. 411, P <0.05). Conclusion The application of TIVA to LC anesthetic effect is satisfaction.

Objective To observe the analgesic effect after cesarean section with different paregoric meth-ods. Methods 100 cesarean patients were randomly divided into A and B group. A group adopted patient controlled epidura analgesia(PCEA) micro-injection pump;B group using patient controlled intravenous analgesia(PCIA) mi-cro-injection pump,patients were observed and recorded for their pain, vomit disgustingly, exsufflation and the time of first urination or accidentally tube pull-out. Results The time of average surgery for A, B group were (53.5±8.5) min, (54.7±8.2) min, between the two groups was not significant (t=1.524, P>0.05) ; A group of visual Analog score (1.49±0.43) points were significantly higher than B group (1.13±0.56) points(t=2.119,P<0.05) ;the incidence of headache, dizziness, nausea and vomiting, skin itching(30.0%, 16.0% ,6.0%) in A group were signifi-candy higher than B group(16.0%,8.0% ,2.0%) (t=2.223, t=2.313, t=2.283, all P>0.05) ; the time of A first exhaust,voiding time[(24.56±8.77) h, (6.51±1.57) h] in A group were significantly higher than B group [(19.29±8.16)h,(4.06±1.76)h](t=2.445,t=2.415,P<0.05). Conclusion PCIA method was safe,effec-tive and allowed patients to have early activities after treatment and to promote early rehabilitation. It should be promo-ted for cesarean section.

Objective To identify the correlation between vitamin D prescription and recurrence in rheumatoid arthritis (RA).Methods A randomized controlled trial study was performed in 170 RA patients who were in remission during the past 2 months.According to the level of vitamin D,170 RA patients were divided into normal vitamin D group (84 patients) and deficiency vitamin D group (86 patients).Deficiency vitamin D group were randomly allocated to receive vitamin D treatment(vitamin D treatment group) or without vitamin D treatment (control group).In the 6-month follow-up period,the recurrence status was observed and compared.Results In the 6-month follow-up period,the recurrence rate of RA in normal vitamin D group was 16.7％(14/84),in vitamin D treatment group was 19.0％(8/42) and in control group was 29.5％(13/44),and there was no significant difference (P ＞ 0.05).In vitamin D treatment group,no hypercalcemia and hyperphosphatemia occured.The age,course of disease and remission time in recurrence patients of three groups were no significant difference (P ＞ 0.05).The level of vitamin D in recurrence patients of vitamin D treatment group was higher than that in recurrence patients of control group:(25.5 ± 8.9) ng/L vs.(20.9 ± 8.6)ng/L,and there was significant difference(P＜ 0.05).Conclusion Vitamin D deficiency is not identified to be a risk factor for RA recurrence.Vitamin D does not reduce the recurrence of RA.

Objective To investigate the influence factors of chronic hepatitis B virus(HBV) infection complicated with chronic liver failure.Methods One hundred and eighty-six chronic HBV infection patients with chronic liver failure were selected as our subjects,who were hospitalized in the Affiliated Hospital of Hebei United University from Jul.2008 to Dec.2013 and they served as case group.Meanwhile,186 patients with chronic HBV infection were selected and served as control group,who were hospitalized during the same period.A self-mad questionnaire was used to collect the information.The influence factors related to HBV infection complicated with acute on chronic liver failure were recorded.Results Multivariate conditional Logistic regression analysis showed that 8 variables were risk factors in terms of chronic HBV infection complicated with acute on chronic liver failure and they were virus overlap infection (OR =6.523,95％ CI:2.034 -10.030),drug application (OR =9.012,95％ CI:3.018-13.241),alcohol (OR =7.2520,95％ CI:1.985 -11.247),bacterial infection(OR =4.378,95％ CI:2.032-5.648),surgical operation (OR =8.514,95％ CI:2.114-17.253),emotional stress and fatigue (OR =2.217,95％ CI:1.729-5.648),genetic (OR =11.124,95％ CI:2.168-13.429),high PCR-HBVDNA quantity (OR =1.628,95％ CI:1.504-3.282).And one protective factorwas the usage of antiviral drug(OR=0.163,95％CI:0.085-0.417).Conclusion The risk factors include virus over infection,application of hepatotoxic drugs,disease before drinking,bacterial infection,surgical operation,emotional stress and fatigue,the genetic parents and high PCR-HBVDNA quantification;and antiviral drugs application is the protective factor in terms of Chronic HBV infection complicated with acute-on-chronic liver failure.

Objective To investigate the association of red cell distribution width (RDW) with outcome in patients with septic shock.Methods A retrospectively study was performed on a total of 156 cases with septic shock who hospitalized in the Affiliated Hospital of North China University of Science and Technology from January 2012 to December 2014.All cases were divided into two groups according to the outcome:survivor group and non-survivor group.The data of general information,combined disease,RDW,acute physiology and chronic health score(APACHE Ⅱ) were collected and compared between the two groups.All cases were divided into three subgroup in regard of RDW,group A was ≤ 14.0％,group B was 14.1％-15.9％,group C was ＞16.0％.Multiple Logistic regression analysis was performed to analyze the related factor of mortality.ROC analysis was used to test the predictive effect of RDW for the outcome of septic shock.Results Sixty-nine cases died in 156,with a mortality rate of 44.2％(69/156).The RDW in non-survivor group was significantly higher than that of survivor group((15.79±2.64) ％ vs.(12.69±3.09) ％,P＜0.001).Mortality rate in each sub-group were 21.5％ (14/65) in group A,49.0％ (25/51) in group B,75.0％ (30/40) in group C,respectively,and the difference among the three groups was statistically significant (x2 =29.396,P ＜ 0.001).Logistic regression analysis showed RDW was independently associated with mortality of septic shock.In reference with group A,the risk of mortality was 3.504 (95％ CI:1.563-7.858,P =0.002) in group B and 10.924 (95％ CI:4.314 -27.661,P＜0.001) in group C.Conclusion Red cell distribution width is a risk factor of mortality in patients with septic shock.

Objective To provide references for reasonable procurement planning, TCM decoction pieces reserving and clinical medication guarantee by analyzing the usage of TCM decoction pieces and granules from 2011 to 2014 in Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine (hereinafter referred to as Zhuhai Hospital). Methods The sale data of TCM decoction pieces and granules during 2011-2014 in the database of Zhuhai Hospital were analyzed. Sales quantity, sales amount of the category and single pieces of TCM decoction pieces and granules ranking the first 10 were analyzed. Results The sales quantity and amount of TCM decoction pieces and granules were increasing from 2011 to 2014. The usage weight ratio and usage amount ratio between TCM decoction pieces and granules was stable. The top 10 categories and single pieces in sales quantity and amount were also stable. Conclusion Zhuhai Hospital has its own characteristics in TCM types, categories and dosage forms. TCM decoction pieces play an important part in clinical treatment in Zhuhai Hospital.

Objective To explore the influence factors of cirrhosis complicated with upper gastrointestinal bleeding,and to guide the clinical treatment of patients with cirrhosis and prevent upper gastrointestinal bleeding.Methods One hundred and seventy-five cases patients with cirrhosis and upper gastrointestinal bleeding were treated in the Infectious Disease Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2015 as the case group.One hundred and eighty-two patients with cirrhosis and no upper gastrointestinal bleeding at the same period in hospital as the control group.A face to face questionnaire was used to fill in the questionnaire.Results Multifactor conditional Logistic regression analysis showed that onset season (OR =4.185,95％ CI:1.874-8.354),non steroidal drugs (OR =6.215,95％ CI:2.681-15.532),drinking (OR =5.481,95％ CI:3.205-11.225),portal vein highpressure gastropathy(OR =7.658,95％ CI:3.227-14.714),diameter of portal vein (OR =8.901,95％ CI:1.218-9.026),liver function classification (OR =13.124,95 ％ CI:2.107-15.228) and esophageal varices (OR =11.021,95％ CI:2.181-13.487) were related with patients with liver cirrhosis complicated with upper digestive tract hemorrhage.Conclusion The onset season,nonsteroidal anti-inflammatory drugs,drinking,portal hypertensive gastropathy,portal vein diameter,liver function classification and esophageal varices are the risk fators of liver cirrhosis complicated with upper digestive tract hemorrhage factors.

Objective To observe the efficacy of 3-dimensional image recombinant guidance in treatment of portal hypertension.Methods A total of 73 cases of portal hypertension were randomized into study and control groups: In study group(n=37),3DCT or MRA imaging display of whole portal venous system was used as guide in selecting portoazygos vein disconnection(P-AVD) operation;in control group(n=36),the classic P-AVD operation was performed.The postoperative complication rate and the degree of amelioration of esophageal varices were cbserved.Results Compared with the control group,the short term rebleeding rate in observation group(0.00%,0/37) was lower than that in control group(11.11%,4/36),improvement rate of esophageal varices in observation group(100%,37/37) was higher than that in control group(86.11%,31/36),and the aggregate rate of portal hypertensive gastric disease and esophageal varices in observation group(0.00%,0/36)was lower than that in control group(13.9%,5/36).There was a statistical difference between the two groups(all P