Objective To discuss the diagnostic value of procalcitonin and C reactive protein in the acute exacerbation period of chronic obstructive pulmonary disease in elderly patients .Methods Patients ages 75 or more with AECOPD were selected ,and the PCT and CRP in blood serum were detected before treated with antibiotics ,then their sensibility and dependability were analyzed . Results Patients were concluded ,the sensibility for CRP>10 mg/L was 92 .19% ,for PCT>0 .05 ng/mL was 43 .75% ,for PCT>0 .25 ng/mL was 28 .13% .The three groups had statistics difference .Patients were divided into three groups according to PCT lev‐el ,CRP had significant difference in the three groups (P<0 .05):the mean value of CRP in PCT<0 .05 ng/mL group was 42 .86 mg/L ,the mean value of CRP in 0 .05 ng/mL

Objective:With a scrutiny of the gastroscope aspects of hepatogenic ulcer (HU),this sutdy was to find out the relationship between HU and hepatocelluar damage and portal hypertension.Methods:262 cases of portal hyprtension of cirrhosis were reviewed with HU being grouped according to the clinical gravity of cirrhosis and the gravity of esophageal varies (EV).Results:①Duodenal ulcer prevails under endoscopy.Superficial ulceration accounted for 70.49% while ulceration less than 0.5cm in full diameter made up 55.74%.The figure was 62.3% with erosive gastritis.②Out of a total of 262,61(23.28%) cases of HU were found in connection with portal hypertension.The χ2 test showed that HU was related with hepatocellular grade and the gravity of EV (P＜0.05).Conclusions:The incidence of HU were higher than normal.indicating that the onset of HU responded positively to the clinical intensity of cirrhosis and the gravity of EV.

Objective To investigate the predictive value of sphingosine‐1‐phosphate (S1P) and adiponectin after coronary stent implantation .Methods Fifty patients confirmed by coronary angiography with in‐stent restenosis were selected as in‐stent resteno‐sis group while 50 patients without in‐stent restenosis were chose as control group .All cases were detected with the density of their serum S1P ,HDL‐S1P ,adiponectin and IL‐18 and analyzed relevance to in‐stent restenosis .Results Compared with the control group ,serum S1P in in‐stent restenosis group were lower [ (96 .10 ± 26 .33)ng/mL vs .(113 .40 ± 32 .72)ng/mL ,P<0 .01] ,and the levels of HDL‐S1P and adiponectin were also significant lower [(32 .81 ± 10 .02)ng/mL vs .(42 .72 ± 11 .75)ng/mL ,P< 0 .01 ;(7 .38 ± 2 .11)mg/L vs .(9 .25 ± 3 .29)mg/L ,P< 0 .01] .IL‐18 levels between the two groups had no significantly difference [(258 .15 ± 82 .19)ng/L vs .(224 .98 ± 84 .15)ng/L ,P>0 .05] .Adiponectin showed a positive correlation between S1P (r=0 .712 , P<0 .05) and HDL‐S1P (r=0 .821 ,P<0 .01) .Conclusion S1P and adiponectin could be independent predictive factor of coronary stent restenosis ,and high concentrations of S1P and adiponectin may reduce risk of in‐stent restenosis in patients with stenting per‐cutaneous coronary intervention (PCI) .

Objective To assess the significance of elevated serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in predicting 30-day mortality rate for patients in intensive care unit (ICU).Methods A retrospective study was conducted.The clinical data of 480 patients admitted to ICU in Tianjin First Center Hospital from June 2012 to October 2013 were studied.The characteristics of patients were recorded,the acute physiology and chronic health evaluation Ⅱ (APACHE I) score was calculated,and the routine blood tests,blood biochemistry,and serum NT-proBNP level within 24 hours after admission were determined.Patients were divided into non-survival and survival groups according to 30-day outcome,and the characteristics and clinical parameters were compared between two groups,and single factor analysis affecting prognosis was analyzed.All patients were divided into four groups according to four percentile method as NT-proBNP＜280 ng/L (group Q1),280 ng/L≤NT-proBNP＜ 1 200 ng/L (group Q2),1 200 ng/L≤NT-proBNP＜1 990 ng/L (group Q3),1 990 ng/L≤NT-proBNP＜4 700 ng/L (group Q4).A Cox regression analysis was used to test the independence of the predictors.A receiver operator characteristic curve (ROC curve) was plotted to compare the power of APACHE Ⅱ score and NT-proBNP in predicting the outcome.Kaplan-Meier analysis was used to assess survival rate among different NT-proBNP patients.Results By single factor analysis it was shown that age,APACHE Ⅱ score,creatinine,NT-proBNP and severe infection were those influencing the outcome.NT-proBNP 1 200-4 700 ng/L (groups Q3 and Q4) and APACHE Ⅱ score ＞20 were independent risk factors for predicting outcome [relative risk (RR) for group Q3 was 3.624,95％ credibility interval (95％CI) was 1.258-10.138; RR for group Q4 was 5.059,95％ CI was 3.202-9.993; RR for APACHE Ⅱ score ＞20 was 2.987,95％ CI was 1.345-5.823].The area under the ROC curve (AUC) for APACHE Ⅱ score and serum NT-proBNP was similar,and it was 0.831 (95％CI 0.778-0.884) and 0.876 (95％CI 0.827-0.925),respectively.The cut-off value of NT-proBNP for predicting mortality was 1 250 ng/L.Kaplan-Meier analysis showed that groups of Q2,Q3 and Q4 had lower cumulative survival rate compared with group Q1 (26.5％,25.4％,16.2％ vs.29.6％),and group Q4 showed most significant extent of lowering of survival rate (x2=122.920,P＜ 0.05).Conclusion Elevated NT-proBNP level in ICU patients signify severity of the disease,and it is an independent predictor of death of ICU patients.

Objective To assess the effect of simvastatin on secretion of VEGF in blood serum and sputum of elderly chronic ob-structive pulmonary disease(COPD)combined with PAH patients and the pulmonary function.Methods Seventy cases of elderly COPD patients combined with PAH patients were randomized in two groups,namely the normal treatment group and combined sim-vastatin group (35 cases in each group),then compare the changes of the VEGF in blood serum,sputum and lung function.Results VEGF in blood serum and sputum showed significant changes after therapies of simvastatin (P <0.05).After 4 weeks′therapy, the FEV1% pre and FEV1/FVC increased significantly (P <0.05).Conclusion Normal treatment combine with simvastatin could decrease VEGF in blood serum and sputum of elderly COPD combined with PAH patients,meanwhile improve pulmonary function.

Background and purpose:The third generation of aromatase inhibitors (AI) in postmenopausal hormone receptor-positive patients is the routine treatments in endocrine therapy. The 500 mg fulvestrant showed clini-cal beneifts in patients with previous AI treatment. This study aimed to access the effcacy and safety of 500 mg fulves-trant in estrogen receptor (ER) positive postmenopausal patients who had previous AI treatments with locally advanced and metastatic breast cancer.Methods:This study retrospectively analyzed the clinical data from 188 post-AI ER positive and (or) progesterone receptor (PR)-positive locally advanced and metastatic breast cancer patients treated with 500 mg fulvestrant in Fudan University Shanghai Cancer Center from Jul. 2011 to Dec. 2015. Primary end point was progression-free survival (PFS). Secondary end points were objective response rate (ORR), clinical beneift rate (CBR) and safety proifle.Results:After the median follow-up of 11.3 months, median PFS was 5.9 months (95%CI: 4.2-7.5), CBR was 40.0% and ORR was 3.4%. COX proportional hazards regression analysis indicated that PFS was correlated with the number of metastatic sites (HR=1.92, 95% CI: 1.2-2.9,P =0.002) and previous lines of chemotherapy (HR=1.52, 95%CI:1.0-2.1,P=0.022). Six patients stopped the treatment for intolerable adverse events.Conclusion:The treatment of 500 mg fulvestrant has a favorable effcacy and safety in treatment of post-AI ER positive postmenopausal patientswith metastatic breast cancer.

100 cases of gastritis verrucosa were classified into acute stage and chronic active stage according to the morpnological and histological characteristics.The CP positive rates in the above two stages were 97% and 68.7%,respectively,while that of the erosion area and the surrounding intact mucosa ' were 83.0% and 45.0%,respectively.The amount of CP was directly related to the degree of inflammatory cell infiltration and erosion.So VG was closely related to CP infection.In the chronic active stage,the detection rates of the Ig coated CP in the tissue section,serum IgA,IgG,and gastric juice IgA were all higher than those in the acute stage (P

Objective:To analyze the expression level of malignant biological marker gene in locally advanced low rectal cancer tissues after neoadjuvant chemotherapy with XELOX, so as to provide guidance for clinical treatment.Methods:Based on the established inclusion and exclusion criteria, 104 patients with locally advanced low rectal cancer treated in the Surgery Department of the Affiliate Hospital of Qingdao University from January 2017 to January 2018 were included in the study. Based on the random number table method, they were divided into observation group and control group, with 52 patients in each group. Radical resection was performed in both groups, while radical resection was performed directly in the control group, and neoadjuvant chemotherapy with XELOX plus radical resection was performed in the observation group. The effect of tumor resection in the two groups was compared and analyzed, and the expression levels of tumor markers and malignant biological marker genes in the tumor tissues after surgery were determined. The 3-year postoperative survival rate of the two groups was followed up.Results:The R0 resection rate was 96.15% in the observation group and 80.77% in the control group, with statistically significant difference ( P<0.05). There were no significant differences in the serum levels of cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and carbohydrate antigen 50 (CA50) before the operation in the two groups ( P>0.05). One week after the operation, the serum levels of CA19-9, CEA and CA50 in the observation group were significantly lower than those in the control group ( P<0.05). Through detection, the relative mRNA expression levels of PPTG and Smad4 in the postoperative observation group were higher than those in the control group, while the relative mRNA expression levels of Runx3 and APC were lower than those in the control group, with statistically significant difference ( P<0.05). The 3-year follow-up survival rate in the observation group was 90.38%, significantly higher than 78.85% in the control group ( P<0.05). Conclusions:The application of XELOX neoadjuvant chemotherapy in radical resection of locally advanced low rectal cancer has important clinical value in reducing tumor malignancy, improving tumor resection effect and improving survival.

Objective: To understand the current situation and associated factors of cellphone usage and addiction among Chinese children and adolescents, to provide reference for effective prevention and intervention of cellphone addiction. Methods: Using a stratified random sampling approach, 11 213 children and adolescents and their parents from 31 provinces, municipalities and autonomous regions in China were recruited and surveyed. Results: The median of daily mobile phone use time among Chinese children and adolescents were 120.00 minutes, as reported by either children or parents. Child s age( β =0.12), hedonic( β =0.11) and social( β =0.09) cellphone use motivations positively related to time spent on cellphone( P <0.01). Cellphone related parental communication( β =-0.06) and knowledge( β =-0.03), as well as cellphone usage on instrumental( β =-0.04) or self representation( β =-0.16) motivation negatively related to time spent on cellphone( P <0.05). Child s age( β =-0.04), cellphone related parental communication( β =-0.09) and awareness( β =-0.14), cellphone use on instrumental motivation( β =-0.22) were negatively associated with cellphone addiction among children and adolescents( P <0.05). Cellphone related parental monitoring( β =0.07), as well as cellphone usage on self representation motivation( β =0.03) or hedonic motivation( β =0.29) positively related to cellphone addiction in children and adolescents( P <0.05). Conclusion Time spent on mobile phone and mobile phone addiction of Chinese children and adolescents are influenced by various internal and external factors, such as the mobile phone use motivation and parenting style.Future school education should help children develop scientific motivation for mobile phone use. Family education should help parents develop positive parenting behaviors such as communication and awareness, so as to reduce the possibility of improper mobile phone use.

Objective:To study the clinical manifestations, diagnostic methods and therapeutic outcomes of transverse testicular ectopia (TTE).Methods:Clinical data of 8 cases of TTE treated in the Department of the First Urologic Surgery, Xinxiang Central Hospital and Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from May 2004 to November 2018 were retrospectively analyzed.Clinical manifestations, diagnostic methods, surgical treatment and follow-up results of TTE were summarized.Results:The age of 8 cases of TTE was 1 year 5 months to 5 years.Among the 8 cases of TTE, 6 cases were involved with the left side and 2 cases with the right side.All patients were admitted due to scrotal emptiness.Three cases were combined with persistent Müllerian duct syndrome (PMDS) and 1 case combined with hypospadias.Preoperative diagnosis of TTE was definitely made in 5 cases, involving 4 cases diagnosed by ultrasound and 1 case diagnosed by magnetic resonance imaging.Laparoscopy was performed in 2 cases, including 1 case treated with laparoscopic scrotopexy, and the other one transferred to an open surgery of trans-septal orchiopexy due to poor development of the spermatic cord.Open surgery was performed in 6 cases, including 1 case with bilateral testicular fixation in the ipsilateral scrotum due to adhesion of spermatic cord closely, and 5 cases with trans-septal orchiopexy.Müllerian ducts residues were excised during surgery in 3 cases combined with PMDS.Postoperative wound infection or hematoma was not reported in all cases.Orchiepididymitis and the involvement of contralateral testes occurred in 1 case treated with trans-septal orchiopexy at 11 months postoperatively, which were relieved after anti-inflammatory treatment.All cases were postoperatively followed up for 3-48 months, and the development and blood supply of bilateral testes were detected normal by ultrasonography.Postoperative testicular atrophy was not reported.Conclusions:The possibility of TTE should be considered in patients with unilateral cryptorchidism combined with contralateral inguinal mass.Ultrasonography is preferred to the diagnosis of TTE.Laparoscopic surgery plays an important role in the diagnosis and treatment of TTE, which is helpful to identify abnormalities in the Müllerian duct structure.