Objective To compare the diagnostic values of different parameters for neonatal sepsis by observing clinical presentations and laboratory tests of hospitalized newborn infants and to find out the the early and fast way in neonatal sepsis diagnosis. Methods Newborn infants admitted to NICU from Sept.2007 to Feb.2008,who met all inclusion and exclusion criteria,were enrolled.The situations in perinatal period,exact time of the onset of infection,clinical manifestations and laboratory indexes were recorded.Infants were classified into 3 groups:septic group(n=13),nonseptic group(n=12) and noninfectious group(n=12).Sensitivity,specificity,false positive rate,false negative rate,Youden's index and positive and negative predictive values(PPV and NPV) were calculated for each test. Receiver-operating characteristic curves were analyzed to determine the optimal thresholds. Results Among all the clinical manifestations,abnormal reaction had the hightest specificity(84.6%) and accuracy(67.9%) in diagnosing neonatal sepsis.SIRS criteria,with the specificity of 95.8%,was helpful in clinical suspected eases.However,routine laboratory tests,such as WBC,PLT and GLU,had poor sensitivity or specificity;I/T had better specificity(100%),but was subject to discrepancy among different observers.The area under the ROC for CRP and PCT were 0.734 and 0.878,with the optimal threshold of 15 mg/L(P=0.020,Youden's index=45.5%) and 0.81 ng/ml(P-0.000,specificity=100%,Youden's index=75.0%),respectively.Conclusions Careful clinical inspection warrants early detection of sick infants.Evaluation of SIRS criteria in clinical suspected septic infants may help in early diagnosis.WBC,I/T,PLT can be used as routinely monitoring indexes for high risk neonates.CRP and PCT concentrations also have significant diagnostic values.

Objective To investigate the diagnosis method of intervertebral disc low back pain and the best treatment clinical efficacy. Methods The imaging data of 132 cases with intervertebral disc low back pain diagnosed by discography for disc imaging was retrospectively analyzed from October 2001 to October 2008. Randomly divided into three groups: group A of pereutaneous laser disc decompression in 63 cases of gasification, group B extraperitoneal anterior disectomy, Cage fusion 21 cases, group C posterior fusion after disectomy arch root 48 cases of screw fixation. Observed in patients with postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) score improvement. Results MRI of lumbar intervertebral disc on T_2-weightod lesions as low signal was important. VAS after treatment in three groups followed by lower values to reduce, group A was (9.7 ± 0.9) points, group B was (7.4 ± 1.2) points, group C was (6.9 ± 1.4) points. There were statistically significance between group A and group B, C (P< 0.05). ODI in order to reduce the value of reducing, group A was (19.4 ± 1.4) points, group B was (18.8 ± 2.9) points, group C was (16.5 ± 2.1) points. There were statistically significance between group A and group B, C (P< 0.05). Conclusions Discography is a reliable method to diagnose intervertebral disc low back pain. Percutaneens laser disc decompression compared with posterior or anterior disectomy and fusion combined with internal fixation has good results in improving pain and function of patients.

Matrix metalloproteinases (MMP) are a family of proteolytic enzymes that degrade various components of the extracellular matrix (ECM).Both animal expodments and clinical sample analysis have shown that balance in expression and activation of MMP and inhibition by tissue inhibitors of matrix metallo-proteinase (TIMP)is critical for the development of stenotic change.This review article focuses on the role of MMP relevant to restenosis after vascular injury.

Objective:To investigate the effects of soluble factors secreted by MCF-7 breast cancer cells on the differentiation,maturation and function of DCs.Methods:Mononuclear cells were cultured with the culture supernatants from primary MCF-7 cells.Combination of granulocyte-macrophage colony stimulating factor(GM-CSF),interleukin 4(IL-4) and tumor necrosis factor-a(TNF-a) was used to stimulate the cultured mononuclear cells.Then DCs and CTL assays were analyzed.Results:MCF-7 cell supernatant-treated DCs resulted in low expression of CD80,CD83,CD86 and HLA-DR,and the inhibition rate of CTL was 17.35% significantly lower than 56.14% induced by the control DCs(P＜0.01).IL-12 secreted by DCs and IFN-γ produced by PBMNC were all significantly lower than those in the control group (P＜0.01).Conclusion:Experiments in vitro shows that the culture supernatants from MCF-7 breast cancer cells could inhibit the development and functions of DCs.

Objective With the development of children 's health care policy, mild Wilson Disease as the first symptom of pa-tients is increasing.In this study, we assessed the reliability of the 2001 international general standards of the Wilson Disease diagnos -tic score.Methods Twenty -one cases of Wilson Disease in children (11 cases were boys, 10 cases were girls, average age was 3 ~10.8 years) included in the study, other 21 cases with liver disease were age-matched and gender-matched.There were no clinical symptoms, only with abnormal liver function in laboratory tests .All the patients with Wilson Disease were all confirmed through genetic diagnosis.Results Receiver operating characteristic (ROC) curve analysis showed that at 20 mg /L threshold, the sensitivity of cer-uloplasmin was 93.4% (95% CI : 81.2% ~98.8%), the specificity was 81.8 (95% CI : 71.6% ~93.6%); urinary copper diag-nostic threshold was 40μg/L/24h, the sensitivity was 75.9% (95% CI :61.7% ~92.4%); the specificity was 89.9% (95% CI :73.7% ~96.6%).WD scoring diagnostic system of the positive and negative predictive values as high as 93% and 91.6%.Penicil-lamine load test in Wilson Disease and control groups , no significant difference between the ROC curve showed a sensitivity of only 10%.Conclusions WD scoring diagnostic system in the mild Wilson Disease patients still has a high diagnostic specificity , but peni-cillamine load test does not have diagnostic significance in some patients .

Objective To investigate the relationship between fatty liver prevalence and body mass index(BMI),dyslipidemia in physical examination population in Baoji area.Methods The height and weight of 10 476 cases of physical examination population were measured and then BMI was calculated.Serum TG,TC,LDL-C and HDL-C concentrations were also determined.Type-B ul-trasonic was used to diagnose fatty liver.The test results were analyzed statistically.Results Fatty liver detection rate of 10 476 physical examination people was 16.29%,the detection rate of abnormal blood lipid concentration was 45.31%;the detection rate of abnormal TG,TC,LDL-C and HDL-C concentrations were 33.05%,17.23%,15.48% and 10%;the prevalence of fatty liver in-creased with BMI(P <0.05);In male population,the detection rate of TG,LDL-C concentrations′abnormal increase,HDL-C con-centrations′abnormal decrease,and fatty liver were higher than that in female population(P <0.05);the detection rate of blood lip-id′s abnormal concentrations and fatty liver were different in people of different age(P <0.05).In male population the group with the highest detection rate of dyslipidemia and fatty liver was the middle-aged group,while in women population was the elderly group.Conclusion There was a significant correlation among BMI,dyslipidemia and fatty liver prevalence,which were different in age and gender.

Pancreatic cancer has the highest mortality among malignant cancers. Known asthe king of cancer,it lacks early symp-toms, diagnostic methods and oncologic markers. Early lymph node metastasis could be found in this disease. Moreover, advanced panereatic cancer is incurable by surgery. Due to the limited efficacy of surgery, as well as radiotherapy and chemotherapy tolerance, therapeutic methods for pancreatic cancer are being explored. L1 cell adhesion molecule (L1CAM) is a member of the cell adhesion molecule inmunoglobulin (Ig) super family that is usually expressed in normal developing nervous tissues. L1CAM is highly expressed in pancreatic cancer cells, binds withα5-integrin to activate downstream factors that mediate tumor metastasis and invasion via the TGF-β1/JUK/slug signaling pathway, induces epithelium-mesenchymal transition, and resists chemotherapy drugs. However, L1CAM forms abnormal vessels that increase the invasiveness of pancreatic cancer cells. This abnormal L1CAM expression in pancreatic can-cer cells is a new therapeutic target in pancreatic cancer treatment. Therefore, future studies on L1CAM could promote the develop-ment of pancreatic cancer therapy and provide new treatment methods.

Objective To study the clinical characteristics and the effect of enzyme replacement therapy for late-onset glycogen storage disease typeⅡ(GSDⅡ). Methods The clinical, laboratory data and the result of genetic testing were retrospectively analyzed in a GSDⅡchild, the effect of enzyme replacement therapy was followed up and the relevant literature was reviewed. Results The patient had motor regression after 1 year old, the serum creatine kinase level is from 675 to 1286 U/L. The EMG test showed myopathic change, acid alpha-glucosidase activity is 12.0 nmol/(g·min), next generation sequencing of genetic muscle diseases panel found the GAA compound heterozygous mutations, both were tiny variations, and muscle biopsies showed the typical pathological features of GSD. The patient was given human recombinant of alpha glucoside enzyme 20 mg per kilogram of body weight, once every other week for 1 year. The weakness of the patient’s muscle strength had no obvious aggravation. Conclusions Early and adequate enzyme replacement therapy is the only possible treatment for GSDⅡ.

Objective To explore the suitable protocols of thoracotomy inhalation program for newborns, which will help to promote respiratory tract secretion drainage and to prevent the postoperative pulmonary complications.Methods This was a double-blind,randomized clinical trial.From January 2011 to October 2013 ,a total of 60 neonatal cases received thoracotomy were recruited,which included 45 cases of congenital esophageal atresia, and 15 cases of congenital diaphragmatic hernia.All cases were randomly allocated into treatment group and control group.Treatment group received mucosolvan 7.5 mg and saline 2 ml oxygen driven inhalation and the control group was given dexamethasone 1 mg, α-chymotrypsin 1 000 U plus saline 10 ml ultrasonic atomizing inhalation.The postoperative incidence of blood oxygen falling when receiving atomizing inhalation and numbers of sputum suction were compared between two groups.Results Compared with control group, the incidences of drop of blood oxygen were significantly deceased [the first day:(0.40 ± 0.35) times vs.(1.53 ± 1.04) times;the second day: (4.32 ± 0.40) times vs.(1.10 ± 1.06) times;the third day: (0.51 ± 0.39) times vs.(1.20 ± 1.09) times;P ＜ 0.05], and the numbers of artificial sputum suction significantly deceased within 3 days after operation [the first day: (7.37 ± 4.92) times vs.(13.24 ± 5.81)times;the second day: (6.34 ± 3.84) times vs.(11.27 ± 4.64) times;the third day: (6.01 ± 2.23) times vs.(10.20 ± 4.53) times;P ＜ 0.05].No adverse reactions were found during treatment.The incidence of blood oxygen falling and the numbers of artificial sputum suction showed no significant differences between two groups on day 4 and day 5 after operation(P ＞ 0.05).Conclusion It is important to have mucosolvan inhalation program for improving condition of respiration and respiratory secretions drainage for newborns with thoracotomy mucosolvan oxygen driven inhalation is worthy being used widely.

Objective To investigate the correlation between fasting plasma glucose(FPG)and body mass index(BMI)among examination groups in Baoji area.Methods 55 328 cases of medical examination were measured height,weight and calculated BMI,then these were detected FPG,the test results were analyzed by statistics.Results The levels of FPG and BMI were significant differences between different gender groups and different age groups;Male and female with abnormal FPG detec-tion rates were 9.90%,5.50%;FPG abnormal detection rate of male higher than female (χ2=335.47,P<0.005).The sub-j ects were divided into four groups according to their BMI:low-weight,normal,overweight and obesity.The relevance ratio of 4 groups with abnormal FPG were 2.71%,5.93%,11.65% and 13.75%,with diabetes were 1.38%,3.18%,6.02% and 6.39%,with impaired fasting glucose (IFG)were 0.8%,2.75%,5.64% and 7.37%.The detection rate of abnormal FPG, IFG and DM detection rate increased with increasing BMI levels (P<0.005).Conclusion The levels of FPG was upward trend with increasing BMI,increased prevalence of diabetes in overweight and obese people.The middle-aged population is the focus of monitoring and intervention of obesity.Control BMI is an effective measure to reduce the occurrence of diabetes.