Objective To clarify diagnostic value of C-reactive protein (CRP) in the pathological types of acute appendicitis in children and the role of CRP as a surgical indication marker for appendicitis.Methods Two hundred and six patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between January 2010 and February 2014,and they were divided into gangrenous appendicitis group(n =53) and non-gangrenous appendicitis group(n =153) by postoperative pathological type.The correlation between preoperative clinical factors and the actual histological severity,and identify surgical indication markers were assessed by multivariate analysis and ROC analysis.Results There were significant differences in white blood count(WBC),neutrophils percentage and CRP level between gangrenous appendicitis group and non-gangrenous appendicitis group(P ＜ 0.05).Multivariate analysis showed that the level of CRP should be a risk factor for judging gangrenous appendicitis.It showed that the role of CRP in judging gangrenous appendicitis was superior to the proportion of neutrophils and WBC in the ROC curve.The ROC curve showed that the area under the ROC curve for the CRP level,neutrophils percentage and WBC was 0.931,0.659 and 0.599 respectively,and the optimal cut off value of CRP for surgical indication for classifying cases was around 44.4 mg/L,and the sensitivity was 75.5 ％,specificity was 93.5 ％.Conclusion The level of CRP is useful in identifying the pathological types of acute appendicitis in children,and can be considered to be a surgical indication marker for acute appendicitis in children.

Objective To explore the expressions and significance of Yes-associated protein (YAP) and large tumor suppressor gene 1 ( LATS1 ) in renal clear cell carcinoma (RCCC).Methods There are 30 cases of RCCC,15 males and 15 females.The median age was 63 (36 - 77) years.There were 17 cases of stage Ⅰ - Ⅱ,13 cases of stage Ⅲ - Ⅳ.There were 8 cases well differentiated,13 cases moderately differentiated and 9 cases low differentiated.The expressions of YAP,LATS1 mRNA and proteins in 30 cases of RCCC and normal renal tissues were tested by RT-PCR and immunohistochemistry,and were analyzed with clinical data.ResultsThe expression level of YAP mRNA in RCCC was higher than that in normal renal tissues (0.569 ± 0.066 vs 0.515 ±0.068,P =0.003 ),and the level of LATS1 mRNA in RCCC was lower than that in normal renal tissues (0.454 ± 0.115 vs 0.514 ± 0.093,P =0.029 ).Thepositive rate of YAP proteins in RCCC was obviously higher than that in normal renal tissues (63.3％ vs 33.3％,P =0.020),and the positive rate of LATS1 proteins in RCCC was lower than that in normal renal tissues (46.7％ vs 76.7％,P =0.017).The positive rate of YAP proteins was 33.3％ in well differentiated tissues,61.5％ in moderately differentiated tissues and 88.9％ in low differentiated tissues ( P =0.018),and the positive rate of LATS1 proteins was 75.0％ in well differentiated tissues,53.8％ in moderately differentiated tissues and 11.1％ in low differentiated tissues (P =0.024).The positive rate of YAP proteins was 47.1％ in stage Ⅰ - Ⅱ and 84.6％ in stage Ⅲ - Ⅳ ( P =0.034 ),and the positive rate of LATS1 proteins was 64.7％ in stage Ⅰ - Ⅱ,23.1％ in stage Ⅲ - Ⅳ ( P =0.024 ).ConclusionYAP and LATS1 play important roles in the development of renal clear carcinoma,and may become new targets in the treatment of RCCC.

Objective To investigate the expression and correlation of interleukin-6(IL-6),myeloid cell leukelia-1(MCL-1) protein and MCL-1mRNA in cervical cancer,cervical intraepithelial neoplasia(CIN) and normal cervix.Methods Immunohistochemistry was used to detect the expression of IL-6 and MCL-1 protein in 30 samples of cervical squamous cell carcinoma,10 samples of CIN and 10 samples of normal cervix,and RT-PCR was used to detect the expression of MCL-1mRNA.Results The protein levels of IL-6 and MCL-1 were significantly higher in cervical cancer tissues than in normal cervix and CIN tissues(P

Objective To study the expression of cyclooxygenase(COX-2) and ki-67 in chronic cervicitis,cervical intraepithelial neoplasia(CIN),squamous carcinoma of the cervix(SCC)and their relationship.Methods Tissue samples were harvested respectively from normal,inflammational,CIN and 30 SCC tissues.The expression of COX-2 mRNA was detected by RT-PCR method.COX-2 and ki-67 proteins were detected by inmmunohistochemical method.Results The overall expression of COX-2 mRNA and protein was higher in inflammation,CIN and SCC groups than that in normal cervix(P

It is an essential educational goal to strength experimental teaching and improving the practical skill of medical postgraduate students in medical colleges and universities.We made anexploration and practice on how to improve the practical skill and innovative ability of postgraduate students in medical immunology experimental teaching.The article points out that optimizing the design of experimental course,innovating the teaching methods,standard appraised of experiment and improving the quality of teacher are the efficient ways to enhance the practical skill of postgraduate students.

Immunology teaching course includes both basic immunology and clinical im-munology.This paper points out the problems of teaching and knowledge integration between the basic immunology and clinical immunology and suggests that teaching team should include the basic immunology and clinical immunology related content clinical experts to promote teaching quality.

Objective To study the feasibility and care mode of remote fetal monitoring at primary hospital. Methods A questionnaire survey was administered to 71 hospitals of different levels in Jiangsu province.Question-naire content included human resources status of midwifery,the remote fetal monitoring system and its clinical applica-tion;anonymous questionnaire survey was conducted to 130 maternal women by random cluster sampling;investigation of remote fetal monitoring device type,operation mode,clinical usage and existing problems was done through the doc-ument retrieval of VIP and Wanfang data platform.Results In grade Ⅱhospital,obstetricians sufficient and insuffi-cient were 10 cases (24.39%),31 cases(75.6%),respectively,and in grade Ⅲ hospital were 8 cases (61.53%), 5 cases (38.46%),respectively,there was statistically significant difference between grade Ⅱ and grade Ⅲ hospital (χ2 =4.572,P <0.05);In grade Ⅱ and grade Ⅲ hospital midwives were obviously insufficient,but there was no sta-tistically significant difference between grade Ⅱ and grade Ⅲ hospital(χ2 =0.219,P >0.05).Different cultural lev-el,place of residence,occupation of maternal demand for the development of remote fetal monitoring were urgent and higher degree of acceptance,but the cognition was not comprehensive,college degree or above,technical personnel and urban pregnant women that their need for remote fetal monitoring were the most urgent.There were significant differ-ences(all P <0.01).The use of remote fetal monitoring equipment was mostly at tertiary hospital nationwide.3G net-work way to transfer data had short time and small scope.Conclusion The existing monitoring system and service mode can not meet the requirements of the implementation of remote fetal monitoring,medical personnel professional quality and maternal comprehensive quality are the main influencing factors.The primary hospitals should actively pro-mote the application of remote fetal monitoring,maternal health care services and health education should arouse the attention of the whole society.

Objective To observe the polymorphism of nitric oxide synthase(NOS)gene and the changes of nitric oxide(NO)in cerebral infarct.Methods The prospective case-control study was employed.Cases contained 193 subjects with cerebral infarction of internal carotid artery system within 2 weeks.Controls contained 103 subjects which came from the normal health checkup.The polymorphism in intron 4 of endothelial nitric oxide synthase(eNOS)gene were detected.NO content was measured by Griess diazotization assay and NOS activity by enzynatic assay.Results There were 48 subjects with allele a in intron 4 of eNOS gene(eNOS4a)in cases and 12 in controls.The frequencies of eNOS4a in cases was higher than that in controls(χ2=8.86,P=0.003).Multivariate Logistic regression analysis confirmed that eNOS4a was an independent risk factors for cerebral infarction(P=0.032).NO production and NOS activity were 6.04(3.83～11.49)μmol/L,(2.97±1.47)U/ml,respectively in cases,and 6.89(4.64～12.43)μmol/L,(3.16±1.46)U/ml,respectively in controls.NO production in cases were significantly lower than that in controls(P=0.022).There was not differential in NOS activity between these two groups(P=0.517).NO production and NOS activity were 5.07(3.18～7.62)μmol/L,(2.77±1.13)U/ml,respectively in the subjects with eNOS4a,and 6.89(4.64～12.43)μmol/L,(3.12±1.54))U/ml,respectively in the subjects without eNOS4a.NO production in the subjects with eNOS4a were significantly lower than that in the subjects without eNOS4a(P=0.001).The NOS activities were not significantly different in subjects with or without eNOS4a(P=0.100).Conclusion eNOS4a possibly exerted some effects on cerebral infarction by diminishing NO.

Objective To study the effect of blood glucose fluctuations on the prognosis of thrombolytic therapy in patients with acute cerebral infarction. Methods A total of 83 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,General Hospital of Beijing Military Command ( the Affiliated 81st Brain Hospital ) from January to November 2013 were enrolled retrospectively. They were divided into cerebral infarction with type 2 diabetes mellitus group (DMCI group,n=47) and cerebral infarction without type 2 diabetes mellitus group (NDMCI group,n=36) according to whether they had diabetes mellitus or not and the results of oral glucose tolerance test at day 7 after admission. Continuous glucose monitoring system ( CGMS) was used to monitor glucose for 72 hours at day 7 after admission. The mean blood glucose, standard deviation of blood glucose level, mean blood glucose fluctuation,and hemorrhagic transformation during the follow-up period,as well as vascular recanalization were observed and compared. At day 90,the modified Rankin scale (mRS) score was used to evaluate the prognosis of the patients. Results ( 1 ) Comparing the dynamic glucose parameters of the patients with acute cerebral infarction in both groups,the mean blood glucose,standard deviation of blood glucose level,mean blood glucose fluctuations at 24 hours in patients of the DMCI group were higher than those of the NDMCI group ( 8 . 3 ± 2 . 6 mmol/L vs. 5 . 8 ± 1 . 3 mmol/L,2. 1 ± 0. 4 mmol/L vs. 1. 6 ± 0. 6 mmol/L,4. 3 ± 0. 8 mmol/L vs. 3. 6 ± 0. 5 mmol/L). There were significant differences (t=31. 419, 15.537,and 15. 372,respectively;all P<0. 01). (2) Four patients (8.5%) in the DMCI group had hemorrhagic transformation during the follow-up period,17 cases (36. 2%) had good recanalization,and 15 cases (31.9%) had good prognosis (the mRS score < 2 at day 90);1 patient (2.8%) in the NDMCI group had hemorrhagic transformation,21 patients (58. 3%) had good recanalization,and 21 cases (58. 3%) had good prognosis. There was significant difference between the recanalization after thrombolysis and the prognosis in patients of both groups (P<0. 05). Conclusion The great fluctuations of blood glucose in acute cerebral infarction patients with type 2 diabetes mellitus may be an important factor of affecting its prognosis of thrombolytic therapy.

Objective: To study the expression of PDCD5 mRNA and its significance in esophageal cancer in Xinjiang Kazakh and Han nationality. Methods: RT-PCR was used to detect the mRNA of PDCD5 in 40 cases of esophageal cancer (18 cases of Kazakh, 22 cases of Han). Results: The positive rate of PDCD5 mRNA expression in 40 samples of esopha-geal cancer tissue, adjacent tissue, and normal tissue was 80.0% (32/40), 80.0% (32/40) and 87.5% (35/40), respectively, with no significant difference (P>0.05). The Ods of cancer tissues, adjacent tissues, and normal tissues were 0.7644± 0.1444, 0.9341 ±0.1631 and 1.8703±0.4767, respectively. The expression of PDCD5 was significantly increased in cancer tissues compared with that in normal tissues (P<0.05). The expression level of PDCD5 mRNA was not significantly correlat-ed with the degree of differentiation and lymph node metastasis. Conclusion: No significant difference was found in PDCD5 mRNA expression in esophageal cancer between Xinjiang kazakh and Han nationality (P>0.05). The expression of PDCD5 is not correlated with the degree of differentiation, depth of invasion or lymph node metastasis. Detection of PDCD5 mRNA expression in esophageal cancer tissues may provide valuable information for patient prognosis.