Objective To study the influencing factors which will lead to depression in patients undergoing orthopedic operation and put forward reasonable nursing countermeasures. Methods 198 patients with orthopaedic operation were investigated using the self-rating depression scale (SDS),social support rating scale (SSRS) and self-designed questionnaire.The influencing factors underwent Logistic regression analysis. Results 105 cases of patients with depression were found among 185 cases,accounting for 56.8％,and 70 cases(66.6％) with mild depression,30 cases(28.6％) with moderate depression,5 cases (4.8％) with severe depressive disorders.SDS score before operation was (37.59 ± 8.74),higher than (33.46 ± 8.55 ) of the national norm.Single factor and multiple factors Logistic regression analysis revealed that paying out-of-pocket for healthcare,worrying about poor prognosis,worrying about the diagnosis and treatment level,considering bad attitude of medical staff were main influencing factors for depression,while social support is a good way to protect patients against depression. Conclusions To cope with the serious depression of orthopedic patients,medical staff should take certain measures to improve patients' psychological quality,so as to achieve the purpose of improving their physical quality.

Objective To investigate the association of restriction fragment length polymorphisms (RFLP) in p.S267F of SLC10A1 gene with clinical outcomes of hepatitis B virus (HBV) infection. Methods Clinical data of 1 268 patients with HBV infections admitted in Public Health Clinical Center Affiliated to Fudan University during July 2014 and February 2015 were collected.Polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP) method was used to genotype the p .S267F of SLC10A1 gene in all patients, and the potential association between variants in p .S267F of SLC10A1 gene and the clinical outcomes of HBV infection was analyzed .Results Among 1 268 patients with HBV infections, 1 226 were of genotype CC, and 42 were of genotype CT, so the variation rate in p.S267F was 3.31%(42/1 268).Compared with patients with genotype CC , patients with genotype CT had a higher incidence of acute HBV infections (13.6%vs.28.6%,χ2 =19.819, P<0.05) and a lower incidence of HBV-related liver cirrhosis or hepatocellular carcinoma (13.9% vs.4.8%, χ2 =18.945, P <0.05). Conclusion RFLP in p.S267F of SLC10A1 gene may be associated with chronicity and aggravation of HBV infection, and genotype CT is possibly a protective factor .

Acute promyelocytic leukemia (APL) was considered to be the most rapidly fatal leukemia,because of serve clinical manifestation,high rate of early death and the low cure rate.APL has achieved great success due to the application of ATRA and ATO.Although the complete remission rate is about 90％,the relapse rate has been reported to be as high as 15％-30％.So reducing the recurrence and improving long-time survival have become the focus of the study.Choosing the reasonable treatment after remission is very important.The post remission therapy usually include consolidation therapy and maintenance therapy,but the optimal strategy has been controversy.Therefore,this artical will review the literature of APL in consolidation therapy.

Objective To evaluate the serum metabolic profiling of acute myocardium infarction (AMI) patients,establish a disease distinguishing model and to select characteristic metabolites with potential clinical diagnostic value.Methods All 42 AMI patients and contemporaneous 35 healthy physical examination adults from May 2011 to March 2012 at the Third Central Hospital of Tianjin.UPLC-LTQ Orbitrap XL MS platform filter characteristics of metabolites.SPSS 17.0 was used for statistical analysis.ROC curve was established to assess the clinical diagnostic value of selected characteristic metabolites.Results PCA (R2X =75.6％,Q2 =39.7％) model and OPLS-DA (R2Y =97.8％,Q2 =97.0％) model were established and 19 ions were identified.Glycerophospholipids decreased in AMI group and sphingophospholipids increased in AMI group.The areas under the curve of all identified metabolites were greater than 0.8.Conclusion Metabolites selected in metabolic profiling analysis show outstanding ability in distinguishing AMI from health people and can be used as potential diagnostic biomarkers and benefit in further clinical study as novel drug targets

Objective Pleural effusion of patients with tuberculous pleurisy was analyzed by ultra high performance liquid chromatography-mass spectrometry (UPLC-MS).Orthogonal partial least squares discriminant analysis (OPLS-DA) model was established for searching and analyzing the potential metabolic biomarkers to provide new ideas for the early diagnosis of tuberculosis pleurisy.Methods Totally 166 cases of pleural samples were collected from November 2012 to September 2013 in Tianjin Haihe Hospital (tuberculosis pleurisy 83 cases,bacterial pleurisy 31 cases,lung cancer 30 cases and heart failure 22 cases)and metabonomics quantitative analysis was conducted.Quantitative analysis of metabolic methods was enrolled.Orthogonal partial least squares discriminant analysis (OPLS-DA) model was constructed by the pattern recognition method.Based on the OPLS-DA model,potential biomarkers was filtered preliminary by variable importance in the projection (VIP) and VIP confidence interval value.The specific metabolites were determined by applying non-parametric test(Kruskal-Wallis H test)by using SPSS 17.0,and potential metabolic biomarkers were screened.Results The prediction accuracy of OPLS-DA model was 100％ (38/38),which illustrated that the model could verify the tuberculous pleurisy group and the control group accurately.Based on the data of metabolites,46 potential metabolites were finally screened and 5 metabolites were identified with statistically significant differences (P ＜ 0.05).The data of tuberculosis pleurisy group showed a significant increase in 17a,20a-Dihydroxy cholesteryl,phospholipid [20∶4 (8Z,11Z,14z,17Z)] (1 188 670.00),tocotrienols (1 051 760.00) and phospholipid(O-18:0) (434 394.00) compared with the lung cancer group(735 615.00,336 815.00,324 563.00,193 055.00),bacterial pleurisy group (1 678 805.00,598 256.50,699 384.00,343 866.00),and heart failure group(535 842.00,253 503.00,234 503.00,130 185.00) (H =26.787,18.680,26.193,21.024,P ＜0.01),and a significant decrease in L-phenylalanine(245 976.00)compared with the lung cancer group(753 033.50),bacterial pleurisy group (357 278.00),and heart failure group(586 678.00) (H =13.635,P ＜ 0.01).Conclusions The OPLSDA model constructed on the basic of UPLC-MS technology platform can verify the tuberculous pleurisy group and the control group accurately,and the study provides new ideas and methods for identifying features of tuberculous pleurisy markers and early diagnosis.

Objective To explore the diagnostic value of combined detection of the liquid array technology, interfer-on (IFN)-γand IFN-γ-inducible protein (IP)-10 in the rapid, accurate diagnosis and differential diagnosis of tuberculous pleural effusions. Methods Patients with transudative pleural effusions were divided into tuberculous pleural effusion group (n=52) and malignant pleural effusion group (n=38). The method of T-SPOT.TB was used to detect the number of effec-tor T cells sensitized to Mycobacterium tuberculosis and spot forming cells (SFCs). The liquid array technology was used to detect the level of IFN-γand IP-10. Logistic regression was used to analyze and compare the diagnostic value of the two-method combination. Results The diagnostic sensitivity, specificity and the area under the ROC curve (AUC) of T-SPOT. TB were 90.38%, 84.21%, and 0.938 (95%CI:0.867-0.978), respectively. The diagnostic sensitivity, specificity and AUC of combined detection of IFN-γand IP-10 were 98.08%, 97.37%, and 0.995 (95%CI:0.951-1.000), respectively. There was no significant difference in the diagnostic sensitivity and specificity between the two methods, and the diagnostic agreement for the two diagnostic methods was fine (Kappa=0.703). The difference of AUC between the methods was significantly differ-ent (Z=1.996, P<0.05). The method of combined detection of IFN-γand IP-10 showed the larger AUC (AUC=0.995). Con-clusion The combined diagnosis meets the clinical needs of rapid, accurate diagnosis and differential diagnosis for tuber-culous pleural effusion by simultaneously assaying the level of IFN-γand IP-10 using the liquid array technology.

Objective To study the effect of lung cancer prevention in Baoji city, one of the cities with high lung cancer morbidity in China. Methods To investigate the mortality of lung cancer from 1992 to 1996 in Baoji and compare it with the data of Baoji in 1970s and the current data in whole China. Information of lung cancer pa- tients was collected from the Malignant Tunout Monitoring Station in Baoji. To investigate by sampling survey the status of smoking of Baoji population based on the principle of clustering random sampling. Information about air pollution in 1980s and 1990s was obtained from the Environmental Monitoring Station in Baoji. ResultsComparing with 1970s, the crude mortality rates of lung cancer in Baoji in 1992～ 1996 increased both in males and females,but the range was narrower than that in whole China. Ajusted mortality rates of lung cancer didn＇t change in females but decreased in males. However, either crude or adjusted mortality rate was lower than the average level of the whole country. The status of air pollution has been improved dramatically since the early 1980s in Baoji. So far, except to- tal suspended particles (TSP), NOx and SO2 levels have reached the Criteria of Air Quality of China. But the smoking rate was still higher. ConclusionThe prevention of lung cancer in Baoji is effective, but the role of measures needs further study. Baoji should not be considered as a city with high lung cancer morbidity in our country at present.

Objectives To investigate the characteristics of changes in serum metabolic profile before and after resection of carcinoma tissues to establish a disease distinguishing model,to analyze the changing trend of characteristic metabolites,and to determine the molecular mechanism and potential clinical value of characteristic metabolic markers for HBV-related liver cancer.Methods Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the serum metabolites of 15 patients with hepatocellular carcinoma (HCC) before and after partial hepatectomy and on 25 healthy volunteers.The pattern recognition method and nonparametric test analyzes were used to analyze the data and to identify the specific metabolites and their changes after resection of carcinoma tissues.Results We established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguishing model for HCC patients before and after operation as against the healthy volunteers.To distinguish between the liver cancer group and the normal control group,27 characteristic metabolites were selected from the patients before and after resection of carcinoma tissues.Eight moved towards the normal control after resection of carcinoma tissues.This indicated that liver carcinoma was an important impacting factor for these metabolites.Finally,7 metabolites were identified,and these metabolites had high diagnostic value as shown on ROC curves.Conclusions Through serum metabolic profiling of patients before and after resection of carcinoma tissues,a high correlation between metabolism and hepatocellular carcinoma was found.Researches on endogenous metabolites and pathways in liver diseases will provide a better understanding of the molecular mechanisms and provide further directions for clinical diagnosis and treatment.

Objective To develop tailored scientific research evaluation indexes for medical personnel with different characteristics in the third grade hospital.Methods 40 experts in clinical medicine were interviewed and 2/3 frequency of their opinions were collected,working plan was developed based on such findings.Results Developed a clear orientation to update the scientific research evaluation system for promotion with consideration of different characteristics of various groups,including young people with high medical trainings,general medical staff,skilled clinicians and full-time researchers.Conclusions The system promoted the development of both individual career and hospital.

Objective To establish a diagnostic model of multiple cytokines for differential diagnosis of tuberculous pleural effusion , and compare its diagnostic accuracy with tuberculosis infected T cells detection ( T-SPOT.TB ) in order to evaluate its diagnostic performance.Methods Case-control study.Totally 147 patients with pleural fluid in Tianjin Haihe Hospital were enrolled and categorized as tuberculous pleural effusion group ( n=95 ) and malignant pleural effusion group ( n=52 ) from December 2011 to June 2013.Pleural effusion cytokines including interferon-γ( IFN-γ) , C-X-C motif chemokine 10 (CXCL-10), tumor necrosis factor-α(TNF-α), vascular endothelial growth factor (VEGF), IL-2, IL-16, IL-17, IL-27 and IL-33 were tested by liquid chip technology and analyzed by Binary Logistic regression and receiver operating characteristic curve (ROC), and the pleural effusion was also detected by tuberculosis infected T cells detection ( T-SPOT.TB) as a control.Results The comparison of the AUC of cytokines is:CXCL-10>IL-27>IFN-γ>IL-33 >IL-17>IL-16>TNF-α>VEGF>IL-2; After that, CXCL-10, IFN-γ, IL-27 and IL-33 were included the Binary Logistic regression model.The regression equation is P=1/1+e-( -16.851+0.390 ×IFN-γ+0.006 ×IL-27+0.020 ×IL-33).The AUC, sensitivity and specificity of the diagnostic model were 99.5%, 96.84%, and 98.08%, respectively.Both AUC and sensitivity of the diagnostic model were superior to those of any single index.Compared with T-SPOT.TB (0.995 ±0.003), the AUC of the diagnostic model (0.921 ±0.023) was significantly greater ( Z=3.235, P <0.01), but no significant difference was found when it comes to diagnostic results consistency (χ2 =0.062 5, P>0.05).The Kappa of the two methods was 0.795, which meant fine agreement of the evaluations of the two raters.Conclusion The application of liquid array technology of high sensitivity and repeatability with high throughput provided a novel insight and method in the clinical diagnosis , treatment and prevention for tuberculous pleural effusion scientifically and accurately.