Objective To establish the biological reference interval of procalcitonin(PCT) applicable for children in Chongqing.Methods Serum PCT level were detected in 120 healthy children with age from 0 to 16 years, including 73 cases of male and 47cases of female children, by using by Maglumi2000 plus PCT analysis system.All data was evaluated according to EP28-A3c document to establish the biological reference interval.Results Data of PCT levels were with non-normal distribution, and without statistical difference between children of different ages and genders(P>0.05).The biological reference interval of PCT was less than or equal to 0.038 μg/L.Conclusion It might be important to establish a usefully biological reference interval in different laboratories with relative detection system, especially for children.

Objective To investigate the clinical efficacy of laparoscopic radical gastrectomy in elderly patients with advanced gastric cancer.Methods The clinical data of 85 elderly patients with advanced gastric cancer who were admitted to the Ningbo First Hospital from January 2012 to June 2014 were retrospectively analyzed.Laparoscopic radical gastrectomy was performed on 46 patients (LRG group) and open radical gastrectomy on 39 patients (ORG group).All the patients underwent primary tumor resection for gastric cancer + D2 lymph node dissection,and the postoperative recovery plans were done according to enhanced recovery program.The volume of blood loss,number of lymph node dissected,operation time,intraoperative arterial partial pressure of carbon dioxid (PaCO2),time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,postoperative hemoglobin,duration of hospital stay and occurrence of complications in the 2 groups were analyzed.The follow-up by outpatient examination and telephone interview was carried out on patients up to August 2014.The count data were analyzed by the chi-square test and Fisher exact probability.The measurement data with normal distribution were presented as x ± s and analyzed using the t test.The t' test was used if the data were deficient.Results Surgical procedures in the 2 groups were successfully carried out and no perioperative death occurred.There was no conversion to open surgery in the LRG group.The resection margins in all the patients were negative.The operation time and number of lymph node dissection in the LRG group were (239 ±68)minutes and 27 ± 10,compared with (227 ±50)minutes and 26 ± 10 in the ORG group,with significant differences (t =0.919,0.179,P ＞ O.05).PaCO2 in the LRG group was (41 ± 5) mmHg (1 mmHg =0.133 kPa),which was significantly higher than(36 ± 5) mmHg in the ORG group (t =4.745,P ＜ 0.05).The volume of blood loss was (102 ± 44)mL in the LRG group,which was significantly less than (200 ± 120) mL in the OPG group (t' =-4.807,P ＜ 0.05).The postoperative level of hemoglobin in the LRG was (110 ± 15) g/L,which was significantly higher than (98 ± 27)g/L in the ORG group (t' =2.471,P ＜ 0.05).The time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,duration of hospital stay in the LRG group were (2.6 ± 0.7) days,(2.1 ± 0.7) days,(1.1 ± 0.3) days,(4.1 ± 0.7) days and (11 ± 4) days,which were significantly different from (4.8 ± 1.5) days,(4.0 ± 1.8) days,(4.5 ± 0.6) days,(5.9 ± 1.8) days and (18 ± 3) days in the OR G group (t' =-8.415,-6.206,-33.831,-5.879,t =9.632,P＜0.05).Eight patients in the LRG group and 15 patients in the ORG group had complications,with the incidence of complications of 17.4％ (8/46) and 38.5％ (15/39),respectively,showing a significant difference (x2 =4.748,P ＜ 0.05).Forty-four patients in the LRG group and 36 patients in the ORG gorup were followed up for 2-25 months,1 patient in the LRG group and 2 patients in the ORG group died and others had full recovery.Conclusions Laparoscopic radical gastrectomy could provide a safe and complete tumor resection for elderly patients with advanced gastric cancer compared with open radical gastrectomy,meanwhile,it can improve postoperative recovery and reduce postoperative complications in elderly patients with advanced gastric cancer.

Objective To compare the sonographic and pathologic features of calcified and non-calcified ductal carcinoma in situ DCIS Methods A total of 83 lesions in 82 consecutive patients with pathologically confirmed pure DCIS were recruited One patient had bilateral lesions All lesions were divided into calcified DCIS and non-calcified DCIS according to the presence of calcifications on mammography Their sonographic features and pathologic reports for all patients with DCIS were retrospectively reviewed Statistical comparisons were performed using the chi-square test Results 1 Calcified DCIS showed positive ultrasound US findings in 80% 44 55 of cases The most common US finding was nonmass lesions 43 6% 24 55 Nine cases had pure ductal dilatations 16 4% 9 55 Non-calcified DCIS showed positive US findings in 96 4% 27 28 of cases The most common US finding was mass 89 2% 25 28 Two cases had pure ductal dilatations 7 1 % 2 28 No significant difference was found in the shape margin orientation posterior feature of a mass between the calcified and non-calcified groups P >0 05 Significant difference was observed in the size boundary echogenicity on ultrasound of the two groups P <0 05 2 At histopathology the pathological scores high nuclear grade positive ER status positive PR status positive Ki67 status and the presence of Her-2 neu oncogene were more common in the calcified group than in the non-calcified group Conclusions Calcified and non-calcified pure DCIS have different pathologic and sonographic features Calcified DCIS has more aggressive histological features than non-calcified DCIS.

Objective To analyze the thin-section CT features of fissure-attached nodules in asymptomatic patients.Methods The baseline and follow-up CT images of 120 asymptomatic patients with fissure-attached nodules were retrospectively analyzed.The thin-section CT findings include size,shape,density,interface,and the relationship with pulmonary fissure.Results There were 1 67 fissure-attached nodules of the 120 patients.The mean length of nodules was 5.46 mm±2.276 mm (2 - 1 5 mm).104(104/1 67,61.1%)nodules were less than 5 mm in length.1 63 (1 63/1 67,97.6%)nodules were typical and 4 (4/1 67,2.4%)nodules were atypical.All these nodules manifested as homogenous,solid,smooth interface,and widely adjacent to the fissure on CT ima-ges.Among those nodules,1 64(1 64/1 67,98.2%)nodules were triangular(88/1 67,52.7%)or oval(76/1 67,45.5%).126(126/1 67, 75.4%)nodules were abutting the major fissure.The angle between nodule and fissure was obtuse in 1 64(1 64/1 67,98.2%)fissure-attached nodules.During follow-up,4(4/1 67,2.4%)nodules increased in size and the corresponding volume doubling time (VDT) range was 863-4 228 days.However,no obvious malignant signs were found.Conclusion The thin-section CT images of fissure-attached nodules in asymptomatic patients showed the benign characteristics,most of which less than 5 mm and demonstrated trian-gle or oval,smooth interface and homogenous solid density.

Objective To evaluate the correlation between thin-section CT morphologic features and pathological vascular invasion in the clinical stage ⅠA peripheral lung adenocarcinoma.Methods The preoperative thin-section CT images,clinical and pathological characteristics of 102 nodules in 98 patients were retrospectively analyzed and divided into two groups according to pathological vascular invasion.Variables including the diameter of tumor(T) and consolidation part (C) in the mix ground glass nodule (mGGN),C/T ratio,morphology and pathological classification were analyzed by two-independent samples Mann-Whitney U test or t test and x2 test or Fisher exact probability test.Variables with significant difference in the univariate analyses were entered into multivariate analysis to explore predictors for vascular invasion.The correlation between these measurements and vascular invasion was evaluated by a ROC analysis.Results All of 102 nodules,36 had pathological vascular invasion and 66 without.The numbers of two groups with speculation,air bronchogram,abnormal vein,vascular convergence,pleural indentation were 30,30;26,26;35,3;35,39;32,39 and the mediandiameter of tumors were 2.1(1.0-3.0),1.2(0.5-3.0) cm respectively.By univariateanalysis,spiculation,air bronchogram,abnormal vein,vascular convergence,pleural indentation,and diameter of tumor were significantly associated with pathological vascularinvasion (P＜0.01).By multivariate logistic analysis,the statistically significant difference were found in speculation and abnormal vein (OR=33.867,8 161.063,P＜0.05).The ROC analysis showed the area under curve,cut-off value,sensitivity and specificity ofthe diameter of tumor and consolidation part of mGGN and C/T ratio were 0.784,2.05 cm,66.7％,78.8％;0.886,1.08 cm,82.4％,90.0％ and 0.861,0.65,79.4％,85.0％ respectively in differentiating tumors with pathological vascular invasion.Conclusion The spiculation sign and abnormal vein are independent predictors for vascular invasion in stage ⅠA peripheral lung adenocarcinoma.

Objective To explore the impact of berberine on serum levels of insulin resistance and cytokines in schizophrenia patients treated with risperidone. Methods Sixty-four schizophrenia patients treated with risperidone were randomized to berberine group (n=31) and control group (n=33). The fasting plasma blood glucose (FBG) and fasting insulin (Fins) were detected before and after treatment in two groups. The homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. The serum levels of interleukin (IL)-1β, IL-6, tumor necrosis factor-alpha (TNF-α) were evaluated by enzyme linked immunosorbent assay before and after the treatment. Results Compared with control group and pre-treatment group, the levels of FBG, Fins, HOMA-IR, IL-1β, IL-6 and TNF-α were significantly decreased after treatment in berberine group (P<0.05). The FBG level was significantly higher, the levels of IL-1β, IL-6 and TNF-αwere significantly lower, after treatment in control group (P < 0.01). There were no significant changes in Fins and HOMA-IR after treatment (P > 0.05). There was positive correlation between HOMA-IR and IL-1β, IL-6 and TNF-α in berberine group (r=0.316, 0.351 and 0.401, P<0.01). Conclusion Berberine can significantly decrease FBG, Fins, HOMA-IR, IL-
1β, IL-6 and TNF-α levels in schizophrenia patients treated with risperidone. The HOMA-IR level is closely correlated with IL-1β, IL-6 and TNF-αlevels.

Objective To explore the expression of cyclooxygenase-1 in ovarian cancer and its significance. Methods Expression of COX-1 and CA125 was detected by immunohistochemistry in 37 cases of ovarian cancer and 31 cases of ovarian cyst. The serum level of COX-1 and CA125 was tested in 40 cases of ovarian cancer and 31 cases of ovarian cyst and 60 healthy volunteers by ELISA. Results The positive expression of COX-1 and CA125 was 78% and 57% in ovarian cancer and 3% and 7% in ovarian cyst,respectively. The expression of COX-1 and CA125 was 65% and 93% at the serum level. Conclusion Expression of COX-1 could act as an auxiliary diagnostic criterion in ovarian carcinoma.

BACKGROUNDTo investigate the expression of COX-2 and its relation to clinical pathophysiological features and prognosis in non-small cell lung cancer (NSCLC).

METHODSThe expression of COX-2 protein was detected in 52 NSCLC tissues by immunohistochemical (S-P) method.

RESULTSThe positive COX-2 expression was observed in 25 (48.1%) cases of NSCLC tissues. The positive rate of COX-2 expression was 76.5% and 34.3% in adenocarcinoma and squamous cell carcinoma respectively (P < 0.01). The positive rate of COX-2 expression in T3+T4 disease (92.3%) was remarkably higher than that in stage T1+T2 (33.3%) (P < 0.01). There was a remarkable difference in COX-2 expression rate between clinical stage I+II (28.1%) and clinical stage III+IV (80.0%) groups (P < 0.01). The positive rate of COX-2 expression was 83.3% in those with lymph node metastasis, but only 17.9% in those without lymph node metastasis (P < 0.01). In addition, there were significant differences in positive rate of COX-2 expression among patients with ≤2, > 2 but < 5, ≥5 years of survival span respectively (P < 0.01).

CONCLUSIONSOverexpression of COX-2 in NSCLC, especially in adenocarcinoma, is closely related to invasion, lymph node metastasis and clinical stage of lung cancer. It may play a role in development of NSCLC, and also may be a prognostic marker.

Adult ; Biopsy, Needle ; Diagnosis, Differential ; Humans ; Kidney ; pathology ; Kidney Diseases ; pathology ; therapy ; Male ; Nephritis, Interstitial ; pathology ; Renal Dialysis ; Sarcoidosis ; pathology ; therapy ; Tuberculosis, Renal ; pathology

Objective To analyze the features of health economics in the treatment of leukemia;To evaluate the improvement trend of levels of clinical diagnosis, treatment and management. Methods TCM medical information dtatabase and electronic medical system in Zhejing Province TCM Hospital from January 2010 to December 2015 were retrived. According to inclusion and exclusion criteria, leukemia patients’ materials that met the critiria were screened. The total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and cost of blood transfusion were set as costs, while white blood cell count, hemoglobin concentration, and platelet count were set as effectiveness indicators for cost effectiveness analysis. Results In patients with low white blood cell count increased unit white blood cell count, patients with high white blood cell count declined unit white blood cell count, patients with low hemoglobin increased unit hemoglobin count and patients with low platelet count increased unit platelet count, the total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and blood transfusionfor the above increases showed a decreasing trend. Conclusion Health economics advantages in three blood routine indicators after treatment of integrated traditional Chinese and western medicine for leukemia is increasing year by year.