Objective To analyze the risk factors associated with respiratory dysfunction (ARD) in patients with DeBakey type Ⅰ aortic dissection after operation and provide the measures for prevention and treatment.Methods Retrospectively analyzed the clinical data of DeBakey Ⅰ type aortic dissection 18 patients under deep hypothermic cardiopulmonary bypass from September 2008 to March 2012 in the application of the three-branch type aortic arch endovascular stent.Recorded age,sex,preoperative complication,with or without perfusion badness syndrome,cardiopulmonary bypass time and aortic cross-clamping time.Monitoring preoperative and postoperative blood gas analysis,chest X-ray,ventilator parameters,intraoperative and postoperative blood transfusion.The single factor analysis of the risk factors associated with postoperative ARD was analyzed.Results No patient died in peroperative period.Five patients (27.8％) was in perfusion badness syndrome preoperative,8 patients (44.4％) was in ARD postoperative.Three patients (16.7％) occurred within 72 h and 5 patients (27.8％) occurred within 48 h.Three patients (16.7％) performed incision of tracheal for the duration of mechanical ventilation for more than 7 d.Correlation factor analysis showed that BMI (P =0.047),cireulatory arrest time (P =0.035) had correlation with postoperative ARD.Conclusions ARD is a common complication during perioperative.It can be correctable by pay full attention to the risk factors,and the prognosis is good.

This article analyzes the characteristics of lymph node metastasis in proximal advanced gastric cancer,in order to guide the extent of stomach resection (proximal or total gastrectomy) and the resection of spleen or splenic preservation. The metastasis of lymph node in proximal advanced gastric cancer has certain characteristics, which can provide a significant guidance for lymphadenectomy. Total gastrectomy plus splenectomy is a feasible radical surgery for proximal advanced gastric cancer, because of the requirement of lymphadenectomy.

Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome (ACS ) before and after rosuvastatin treatment .Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study .T heir blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated .Their association with serum IL-17 level was analyzed .Patients in group A were treated with rosuvastatin .The serum IL-17 levels were compared in two groups before and 4 weeks after rosuvastatin treatment .Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment (34.41 ± 6 .37 ng/L vs 15 .18 ± 3 .11 ng/L ,P<0 .05) and significantly lower in group A 4 weeks after rosuvastatin treatment than before rosuvastatin treatment (16 .71 ± 4 .72 ng/L vs 34 .41 ± 6.37 ng/L ,P<0 .05) .No significant difference was found in serum IL-17 level between the two groups after rosuvastatin treatment (P>0 .05) .Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17 level (P=0 .012 ,0 .008 ,0 .000) .Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS .Early treatment of ACS with rosuvas-tatin can reduce the inflammatory reactions and serum IL-17 level ,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS .

Objective To investigate and analyze the reference ranges of the common parameters of venous blood cell analysis a ‐mong healthy adults in Kunshan City .Methods The analytical results of venous blood cells from 2 456 healthy adults were selected and the ten indicators of red blood cell ,hemoglobin ,mean corpuscular volume ,mean corpuscular hemoglobin concentration ,mean corpuscular hemoglobin ,hematocrit ,white blood cell ,lymphocytes percentage ,neatrophilic granulocyte percentage ,blood platelet were statistically analyzed by adopting the SPSS 19 .0 software .Results The commonly used 10 parameters of blood cells showed a skewed distribution ,the Mann‐Whitney U tests showed that the gender difference in 10 parameters was statistically significant (P<0 .05) ;the WBC count was slightly higher than that reported by other literature ,the other 9 parameters were close to those reported by the majority of related literature .Conclusion The commonly used parameters of blood cell analysis are influenced by the region , gender ,environment ,living condition and detection instrument ,and it is necessary to establish the reference ranges for each labora‐tory .

To study the clinical application of molecular diagnosis in cutaneous T-cell lymphoma (CTCL),the polymerase chain reaction Was used to detect the rearrangements of T-cell receptor (TCR)gene in 60 patients with cutaneous lymphocytic infiltrates.The result showed that dominant clonal TCR-? or ? gene rearrangements were detected in 36/40 CTCL,4/6 suspected mycosis fun- goldes/S?zary syndrome,1/1 lymphomatoid papulosis.No dominant clonal TCR-? or ? gene rearrange- ments were detected in 2 patients with CBCL,1 patient with lymphocytoma cutis,8 patient with benign lymphocytic infiltrates of skin and 2 normal controls.This study demonstrates that the method is help- ful for the lineage determination,clonality and early diagnosis of CTCL.

AIM To evaluate the changes of serum and brain tissue endoxin in model of bilateral cerebral hemisphere ischemic reperfusion injury, and effect of anti digoxin antiserum (an antagonist of endoxin). METHODS The bilateral cerebral hemisphere ischemic model was prepared by ligating three vascular by Kameyama's manner. SD rats were randomly divided into 7 groups and each group had 8 rats. Sham group, ischemic reperfusion group, negative control group, nimodipine group, low concentration anti digoxin antiserum group, middle concentration anti digoxin antiserum group, high concentration anti digoxin antiserum group. The blood was collected at the end of reperfusion, meanwhile rats were killed, and the bilateral cerebral hemisphere were took out and used to prepare encephlon homogenate and made into samples of light microscope. RESULTS Compared with sham group, the serum CK content increased; Brain tissue SOD activity reduced and MDA content increased importantly in ischemia reperfusion group; The levels of serum and brain tissue endoxin in ischemia reperfusion group were significantly higher, while ATPase activity in brain tissue decreased; Mitochondrial Ca 2+ content in brain tissue increased significantly and Mg 2+ content decreased significantly. In brain tissue,there was some inflammatory change and local necrosis;The rank order and structure of cell wasn't clear;The morphology of pyramidal cell was abnormal. Compared with ischemic reperfusion group, Anti digoxin antiserum reduced serum CK content; It antagonized lowering of SOD activity and increase of MDA content in brain tissue; It remarkably reduced the level of brain tissue endoxin; It reduced abnormal ion content of brain tissue mitochondrion induced by cerebral ischemic reperfusion injury; The high and middle concentration anti digoxin antiserum had a significant effect on raising brain tissue ATPase activity. It reduced neuron denaturation. CONCLUSION Cerebral ischemic reperfusion can increase the level of brain tissue and serum endoxin and higher endoxin can promote brain injury. Endoxin is a major factor involved in cerebral ischemic reperfusion injury. Anti digoxin antiserum can reduce brain tissue injury and had a protective and treatment effect on cerebral ischemic reperfusion injury by antagonizing the effect of endoxin.

To improve the quality of medical postgraduate students in our school and to meet the needs of basic medicine and the development of personalized medicine , we opened the course“molecular pathology” to medical graduates. To make the molecular pathology the true bridge course between basic medicine and clinical medicine, we optimized the content of molecular pathology, cre-ated diagnostic technical platform matched with molecular pathology, rationalized management system worked in the basic pathology and clinical pathology. Practice has proved that “molecular pathology”curriculum promotes medical postgraduate students' transformation of medical philosophy, cultivates their innovation ability in scientific research and clinical practice ability etc.

Objective To explore the clinical significance of cytokines expression including CD11b,CD18,IL-8 and IFN-? in patients with psoriasis.Methods 55 patients with psoriases,including vulgaris,pustulosa,arthropathica and erthrodermic ones,were enrolled into the case group and 40 healthy persons as control.The expressions of CD11b,CD18 were detected by flow cytometry,while IL-8 and IFN-? with ELISA.Results The expression of CD11b,CD18,IL-8 and IFN-? in patients with psoriasis was significantly higher than those in control.Conclusions The ultra expression of CD11b,CD18,IL-8 and IFN-? might relate with the immunopathology of lymphocyte cell activation in psoriasis.This might provide the dependable basis for its treatment.

OBJECTIVE To check the defects of nosocomial infections reports,recording of the patient′s history,and antibiotics usage,so as to improve hospital management and reduce nosocomial infection.METHODS Patient′s records from Jan 1,2008 to Dec 31,2008 were reviewed to find out the defects and feedback to the physicians.RESULTS Some problems of 5995 cases were checked out and corrected,some suggestions were made.CONCLUSIONS Checking the patient′s records may supplement the defects of prospective monitor,direct the antibiotics therapy,and monitor occurrence of drug resistance.

ObjectiveTo investigate the characteristics of three vaginal bacteria inspection methods of Amsel method,gram staining Nugent score method and bacterial vaginosis (BV) Blue methodMethods The leucorrhea specimen of 99 vaginal fluid abnormal patients were examined by Amsel method,gram staining Nugent score method and BV Blue method,then compared and analyzedResultsThe positive rate was 28.28％ (28/99) in Amsel method,47.47％(47/99) in gram staining Nugent score method and 16.16％ (16/99) in BV Blue method.There were significant differences among three methods(P＜ 0.01 ).The specificity and sensitivity of gram staining Nugent score method was higher.ConclusionThe three vaginal bacteria inspection methods have advantage and shortcoming individually,suspecting patients should be followed up to detect and diagnose in chnic,or detected by many methods.The specificity and sensitivity of gram staining Nugent score method is higher,but BV Blue method is simple,faster,which has higher value in detection and diagnosis in BV.