Objective To investigate the expression of osteopontin in colorectal cancer and hepatic metastatic cancer and its clinical significance.Methods The expression of osteopontin in 76 cases of colorectal cancer tissues,30 para carcinoma normal mucosa,liver metastatic tumor tissues in 16 patients was examined by immunohistochemical SP staining method.Results The expression rates of osteopontin in normal mucosa,colorectal cancer tissues and liver metastatic cancer tissues were 6.7％ (2/30),69.7％ (53/76),75.0％ (12/16) respectively.The expression rates of osteopontinin colorectal cancer and liver metastatic cancer was significantly higher than those in the normal mucosa (respectively x2 =34.273,23.014,all P ＜ 0.001).The expression of osteopontin was related to infiltration depth,lymph node metastasis,and distant metastasis (respectively x2 =14.347,6.577,7.278,5.537,all P ＜ 0.05).There was no significant difference in the sex and age.Kaplan-Meier survival analysis showed that patients with osteopontin positive had poor prognosis compared with osteopontin negative patients (P ＜ 0.001).Conclusions The expression of osteopontin is closely related to the invasion and metastasis of colorectal carcinoma,a hopeful indicator for the prognosis of colorectal cancer.

Objective To observe the effects of blood pressure by intravenous infusion of different doses ofoxytocin in cesarean section.Methods Sixty full-term pregnant women undergoing cesarean section with continuous epidural anesthesia were divided into three groups by random digits table method with 20 cases each:group A,B and C.Three groups were injected 10 U oxytocin in uterine muscle after infant delivery.Group A,B and C received 5,10 and 20 U oxytocin (sodium lactate ringer,500 ml) continuous intravenous infusion at the speed of 10 ml/min.If happened uterine contractions bad,they were sublingual administering 0.2 mg misoprostol.If happened severe hypotension,they were intravenous injected 5 mg ephedrine.The change of mean arterial pressure (MAP) and heat rate before anesthesia (T0),after fetal childbirth (T1),5 m in (T2),10 min (T3),30 min (T4) after infusion of oxytocin and the dosage of ephedrine and misoprostol were recorded.Results There were no significant differences in MAP and heart rate at every time point between group A and B (P＞ 0.05).MAP decreased and heart rate increased in group C at T2,T3 compared with those in group A and B,and there were significant differences (P＜ 0.05).The number of cases of sublingual misoprostol were increased in group A (7 cases) compared with that in group B (2 cases) and group C(1 case).The 8 patients injected ephedrine in group C were more than group A(1 case) and group B (3 cases).Conclusion Cesarean section after the delivery of the fetus in the uterus muscle injection of oxytocin 10 U,after 10 U of oxytocin added 500 ml sodium lactate ringer injection at the speed of 10 ml/min intravenous infusion has little effect on the blood pressure and heart rate,and has good uterine contractions.

Professional postgraduates in geriatric medicine are one of the most important re-courses of geriatric specialists. However, training model for geriatric postgraduates is still unclear in China. In general, geriatric medicine has no independent training plan, and is included in internal medicine training. Such model cannot represent the feature of geriatric medicine. The present paper aimed to discuss the ability construction for geriatric postgraduates based on the geriatric medicine specialist training experience both at home and abroad, including diagnosis and treatment of multi-system diseases, ability of geriatric assessment, management of geriatric syndromes, consultation for geriatric rehabilitation and ability for continuity health service in order to cultivate the compound tal-ents suitable for the aging society requirement for geriatric medicine in China.

Objective To understand the epidemiological characteristics of brucellosis among risk population and analysis risk factors, and to provide a reference basis for prevention and treatment of brucellosis. Methods Retrospective survey method was used to collect information on brucellosis and epidemiologically confirmed cases in Tongxiang City from 2010 to 2015. The employees gender, age, occupation, job seniority, contact area, contact history to abortion cub and with or without protection measures were analyzed by single factor and multiple factors analysis, calculate odds ratio (OR) and 95%confidence interval (CI). Results Totally 1 450 people were investigated and 43 were confirmed positive (2.97%),new cases were 37 with joint pain 86.49% (32/37), low temperature 81.08%(30/37), and weak 62.16%(23/37) as the main body symptoms. Most people were infected in the summer season, accounted for 8.07%(18/223); female cases were relatively higher, accounted for 5.38% (12/223);people younger than 30 years old had the highest positive rate 24.14%(7/29);people working in the processing of animal products had the highest positive rate 6.42%(12/187). The employees gender, age, the types of work, the job seniority, the district distribution and the season were all related to the prevalence of the disease (all P< 0.05) analyzed by Chi-square test and Fisher's exact probability method. By single factor analysis, gender (male, OR =0.397, 95%CI:0.178-0.884), age (31-60 years old, OR = 0.254, 95%CI:0.081-0.796), and types of work (processing personnel, OR =3.211, 95%CI: 1.424 - 7.238) and contacting young animal (OR = 3.544, 95%CI: 1.729 - 7.264), practitioners operating tool (OR=0.231, 95%CI:0.070-0.766) were related to the prevalence of the disease;by multiple factors analysis, contacting young animal (OR=5.198, 95%CI:2.078-13.000) was a risk factor for brucellosis abortion, and practitioners operating tools (OR = 0.161, 95%CI: 0.045 - 0.577) were brucellosis protective factors such as wearing gloves . Conclusion We suggest to strengthen health education and health promotion in professional key populations, do a good job in the epidemic monitoring and promote occupational protection awareness, and decrease the infection of brucellosis.

Urinary tract infection complicated with urinary tract calculi( lithangiuria)is one of the most common diseases causing serious urinary sepsis and septic shock. Recent studies show that the accurate diagnosis,rational use of antibiotics and timely treatment of complications are the key to treatment success. In this article,the latest progress and the treatment strategies for urinary tract infections complicated with lithangiuria are explored.

In medical clinical study, the researchers and the ethics committee members' personal economic in-terests and responsibilities conflicts may produce damage to experimental research and the subjects, may make the study being questioned the authenticity and the objectivity of clinical trial results, also damage to the subjects' rights and interests and damage the credibility of hospital. In order to prevent the happening of the conflict, put forward the strategies:strengthen legislation construction, improve the treatment method, set up a conflict of interest com-mittee, adhere to the principle of open, review and restriction to the personnel, regularly organize researchers and ethics committee members attend the training.

Objective To analyze the differences in the clinical characteristics,endoscopy,pathology and therapy between the patients with new onset ulcerative colitis(UC) in the elderly versus youth and middle-aged patients.Methods A review analysis was carried out in the 178 hospitalized patients with UC in Third Hospital of Peking University from 1994 to 2010.The patients were divided into two groups according to the age of onset:UC onset at age of 60 years and older were enrolled in elderly group; UC onset at age less than sixty years were enrolled in youth and middle-aged group.The data of clinical manifestation,endoscopy,pathology,laboratory test,the severity of disease classification and therapy were analyzed and compared between the two groups.Results The elderly group consisted of 21 men and 6 women.The youth and middle-aged group consisted of 83 men and 68 women.The ratio of male was higher in elderly group than in youth and middle-aged group (77.8％ vs.55.0％,P＜0.05).No significant difference in the clinical type of UC was observed (P＞0.05).The ratio of abdominal pain in elderly group was lower than in youth and middle-aged group (44.4％ vs.78.8％,P＜0.05).There were no significant differences in other symptoms,laboratory test and the severity of disease between the two groups (all P＞0.05).The ratio of Grade Ⅰ and Ⅱwas much higher in the elderly than in youth-middle-aged group(70.4％ vs.39.9％,P＜0.05),but the ratio of Grade Ⅲ and Ⅳ was much lower in the elderly than in youth-middle group(29.6％ vs.60.1％,P＜0.05).No significant differences between the two groups were found in the extent of disease,pathological characteristics and therapy (all P＞0.05).Conclusions Compared with the youth and middle-aged patients with onset UC,the ratio of male patients was higher,the ratio of abdominal pain was lower,and the severity of endoscopic manifestation was less in the elderly patients with onset UC.

Objective To study the therapeutic effect of EUS-guided biliary drainage (EUS-BD) on patients with malignant obstructive jaundice when ERCP failed.Methods From January 2014 to January 2016,all patients with malignant obstructive jaundice during hospitalization underwent EUS-guided biliary drainage (group A,36 cases) or PTCD treatment (group B,30 cases) by draw after failed ERCP.Operation success rate,liver function recovery time,complication rates,length of hospital stay and hospital costs were observed and compared.Results There was no significant difference in the operation success rates between two groups [94.44％ (34/36) VS 86.67％ (26/30),P＞0 05)].And there were significant differences in liver function recovery time (25.79± 6.48 d VS 30.24 ± 8.49 d),incidence of complications [5.56％ (2/36) VS 23.33％ (7/30)],length of hospital stay (21.54±4.73 d VS 25.68 ± 8.56 d) and hospitalization costs (23.5±8.4 thousand yuan VS 32.8±6.5 thousand yuan,P＜0.05).Conclusion EUS-guided biliary drainage could be the first option for its noninvasiveness and efficacy,when ERCP failed in patients with malignant obstructive jaundice.

Objective To evaluate the safety and diagnostic accuracy of preoperative endoscopic ultrasound-guid﹣ed fine-needle aspiration in patients with pancreatic cancer. Methods 256 patients with pancreatic cancer from Jan﹣uary 2010 to December 2014, 82 were considered resectable on the basis of cross-sectional imaging findings. Of these patients, 54 underwent EUS-FNA before surgery (FNA+group) and 28 underwent surgery without preoperative EUS-FNA (FNA- group), the diagnosis result of EUS-FNA and the survival time of the two groups were observed. Results All 54 lesions were visible on EUS, and all 54 attempts at FNA were technically successful. The diagnostic accuracy according to cytology and histology findings was 94.44 % (51/54) and 88.89% (48/54), respectively, and the total accuracy was 94.44 % (51/54). Two patients developed mild pancreatitis and two hemorrhage after EUS-FNA but were successfully treated by conservative therapy. No severe complications occurred after EUS-FNA. In the FNA+and FNA- groups, the median relapse-free survival (RFS) was 282 and 265 d, respectively (P>0.05), and the median overall survival (OS) was 568 and 557 d, respectively (P>0.05). RFS and OS were therefore not inferior in the FNA+group. These data indicate that the usage of EUS-FNA did not influence RFS or OS, nor did it increase the risk of other complications. Conclusions Preoperative EUS-FNA is a safe and accurate diagnostic method.

Objective To explore the expression of pituitary tumor transforming gene (PTTG) and c-myc gene in patients with non-Hodgkin lymphoma (NHL),its relationship with NHL and its clinical significance.Methods PTTG mRNA and c-myc mRNA levels in bone marrow mononuclear cell (BMMNC) isolated from 38 NHL patients and 10 chronic lymphadenitis patients were quantified by reverse transcriptionpolymerase chain reaction (RT-PCR).Results mRNA expression of PTTG and c-myc gene in BMMNC was significantly higher in NHL patients than those in normal controls (PTTG:0.567 7±0.270 7 vs 0.071 2± 0.020 1,t =4.706,P ＜ 0.05; c-myc:0.352 6±0.185 4 vs 0.107 3±0.043 5,t =3.303,P =0.002).The expression of PTTG and c-myc gene in peripheral T cell lymphoma and diffuse large B cell lymphoma showed no significant difference (PTTG:0.556 8±0.211 3 vs 0.602 8±0.244 6,t =0.640,P =0.527; c-myc:0.350 1± 0.177 6 vs 0.361 0±0.190 2,t =0.302,P =0.765).Both expression of PTTG and c-myc were positively related to NHL clinical stage and IPI.Expression of PTTG mRNA was positively related to the expression of c-myc mRNA.Conclusion There was overexpression of PTTG and c-myc in NHL,which indicates that PTTG might be involved in tumorigenesis of NHL through direct or indirect activation of c-myc oncogene.