Objective Using ROC curve to determine the best cut-off point of serum HE-4 in the diagnosis of ovarian cancer and provide important value to diagnosis early ovarian cancer.Methods The levels of serum HE-4 in 68 ovarian cancer pa-tients,42 ovarian benign tumor patients and 30 healthy female were detected by electrochemistry irradiance method.The ROC curve was drawn and the cut-off point of HE-4 was determined by statistical software.Results The levels of serum HE-4 were all non-normal distribution in the groups of ovarian cancer,ovarian benign tumor and healthy controls.Whats more,there was no significant difference between ovarian benign tumor group and normal control group.And compared with benign ovarian tumors and normal control group,the level of HE-4 in ovarian cancers was significantly increased (P <0.01).It would be best for diagnosis when the level of serum HE-4 was 108pmol/L in ovarian cancer.Youden’s index showed the maximum (0.713)and the sensitivity and specificity of diagnosing were 77.9% and 93.1% respectively.The positive predictive value was 91.4% and negative predictive value was 91.4%.At the same time,the positive likelihood ratio was 11.6 and the negative likelihood ratio was 0.2,odds ratio reached to 47.3.Conclusion The detection of HE-4 is an ideal mark for diagnosing and excluding ovarian cancer.Selecting 108 pmol/L as ovarian cancer diagnosis point is relative appro-priate.

Objective To investigate the effects of continuous invasive mechanical ventilation combined with BAL on COPD patients with respiratory failure. Methods Sixty COPD patients with respiratory failure were divided into BAL and control group randomly. Control group were treated with sputum suction tube to aspire sputum and BAL group treated with BAL. The changes in the indicators were observed. Results The SpO2, airway peak inspiratory pressure and blood gas analysis were improved significantly compared with the control group (P < 0.01). The number of peripheral blood leucocytes and the level of CRP in BAL group were lower than those in control group at the seventh day (P < 0.01). The duration of invasive mechanical ventilation and hospital stay in BAL group was shorter than that in control group (P < 0.01) and there was no severe complication in both groups. Conclusion BALwith continuous mechanical ventilation support are safe and effective and shorten hospitalization time and improve the prognosis of COPD patients with respiratory failure.

BACKGROUND:Recent research has shown that transplanted bone marrow mesenchymal stem cells(BMSCs) migrate to the injured regions and exert their therapeutic effects in cases of intracranial trauma, stroke, inflammation and degenerative disease.The specific mechanisms involved in their migration to lesions are still to be fully elucidated.OBJECTIVE:To explore the effects of stromal cells derived factor-1(SDF-1) and its receptor CXCR4 on the migration of transplanted BMSCs to ischemic brain lesions.DESIGN, TIME AND SETTING:The cytological in vivo study was performed at the Central Laboratory, Xinqiao Hospital, Third Military Medical University of Chinese PLA from February 2008 to February 2009.MATERIALS:Bone marrow samples were obtained from normal or primary affection non-involved bone marrow patients aged 15-40 years at the Department of Hematology, Xinqiao Hospital, Third Military Medical University of Chinese PLA.A total of 72 healthy male Sprague Dawley rats aged 3-4 months were supplied by the Experimental Animal Center, Research Institute of Surgery, Third Military Medical University of Chinese PLA.METHODS:Human BMSCs were isolated by combination of gradient centrifugation and different adherent time method.The transient middle cerebral artery occlusion(MCAO) was induced using intraluminal vascular occlusion in 54 rats, based on the method described by Nagasawa et al.The remaining 18 rats served as sham operation group, only inserted with thread for 10 mm depth.At 2, 4 and 8 days after cerebral ischemia, the expression of SDF-1 in the ischemic brain was determined by real time RT-PCR and immunohistochemistry in 9 rats from either group.The remaining 36 rat models of cerebral ischemia/reperfusion were equally and randomly assigned into a cell transplantation and solution control groups.1 mL human BMSCs(2?109/L cells) or 1 mL phosphate buffered saline were slowly infused through the caudal vein at 24 hours following reperfusion.MAIN OUTCOME MEASURES:CXCR4 mRNA and protein expression in human BMSCs was determined.SDF-1 mRNA and protein expression following ischemia/reperfusion were detected.Migration of transplanted human BMSCs into the damaged region was observed through immunohistochemistry.RESULTS:RT-PCR showed that human BMSCs were positive for CXCR4 mRNA.Immunocytochemistry revealed that CXCR4 mainly expressed in cell membrane and cytoplasm of human BMSCs.At 2, 4 and 8 days following cerebral ischemia/reperfusion, SDF-1 mRNA levels showed an increased tendency, and showed significant difference compared with the sham operation group(P

BACKGROUND: Transplanted bone marrow mesenchymal stem cells (BMSCs) migrate to the injured regions and exert their therapeutic effects. The specific mechanisms involved in their directional migration to lesions remain unclear. OBJECTIVE: To investigate the chemokine receptor CXCR4 and CX3CR1 expression of human BMSCs in hypoxia culture. DESIGN, TIME AND SETTING: The cytology in vitro study was performed at the Central Laboratory, Xingqiao Hospital, Third Military Medical University of Chinese PLA from February 2008 to February 2009. MATERIALS: Cells harvested from the iliac heparinized bone marrow were obtained by iliac crest aspiration from healthy adult volunteers, aged 15 to 40 years old, at the Department of Hematology, Xinqiao Hospital, Third Military Medical University of Chinese PLA. METHODS: Bone marrow was obtained by puncture. Human BMSCs were harvested by combination of density and gradient centrifugation and different adherent method. Cells at passage 3 were incubated in a 25 cm2 flask. When 70%-80% confluence was found, cells were incubated at 37 ℃ and saturated humidity in an incubator containing 3% O2, 5% CO2, 92% N2 for 48 hours, and those incubated under normal oxygen as controls. MAIN OUTCOME MEASURES: Morphology was examined by phase contrast microscopy. Cell surface markers were tested by flow cytometer. The CXCR4 and CX3CR1 mRNA expression were detected by real-time PCR. The CXCR4 and CX3CR1 protein expression were determined by Western blot assay. RESULTS: All of the cells had a fibroblast-like morphology cultured in vitro and reached 90% confluence at 12-14 days, with the presence of polarity arrangement and whirlpool-shape. Cells were uniformly positive for CD105 (99.38%) and CD29 (99.13%), but negative for CD14 and CD45. Exposure of BMSCs to 3% O2 increased expression of the CXCR4 mRNA and CX3CR1 mRNA, which were respectively 2.130 times and 2.361 times of normal culture; expression of the CXCR4 protein and CX3CR1 protein was respectively 1.69 times and 1.93 times of normal culture. CXCR4 and CX3CR1 mainly expressed in membrane and cytoplasm of human BMSCs. CONCLUSION: Hypoxia (3% O2) can upregulate the expression of CXCR4 and CX3CR1 in human BMSCs, which might be one of the machenisms underlying the migration of BMSCs.

OBJECTIVE To discuss the efficiency method of improving consciousness and action for occupational infection protection among grass root medical staff.METHODS To conduct multiform health education,found restrict system,inspect and supervise,optimize protection flow,consummate protection establishment,and strengthen important link management in key departments in order to realize the system intervention among grass root medical staff.RESULTS Due to the system intervenion,the understanding rate of occupational infection protection knowledge improved from 48% to 96%,the average rate of occupational infection protection improved from 56.6% to 97.7% with significant differences(P

Objective To explore the compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis.Methods Data of 296 patients with spinal tuberculosis from January 2000 to January 2011 were retrospectively analyzed.All patients were divided into two groups according to completeness of debridement:complete debridement group (group A) and incomplete debridement group (group B).There were 162 cases in group A including 86 males and 76 females,with an average age of 38.74± 17.26 years.There were 134 cases in group B including 73 males and 61 females,with an average age of 35.64± 18.21 years.All paticnts had undergone anterior debridement,focal graft implantation,anterior or posterior deformity correction,and internal fixation.Regular follow-up was required in the two groups.Results Residual sclerotic walls (36.54％),multipie cavities (34.62％),affected bony bridges (13.46％),sequestmm (3.37％),abscess (7.21％) and other lesionses (4.81％) were found in the group B.The first three factors were made up 84.62％ of the total.The mean follow-up time was 76.13±8.32 months in the group A and 79.24±5.49 months in the group B.The symptoms,C-reactive protein and erythrocyte sedimentation rate were improved more obviously in group A than those in group B.Six months after operation,tuberculosis healing rate in group A and group B was 29.01％ (47 patients) and 4.48％ (6 patients),respectively.The mean healing time was 4.36± 1.27 months in the group A and 9.15±2.53 months in the group B,with significant differences.The mean the time of chemotherapy was 5.21± 1.38 months in the group A and (10.45±2.15) months in the group B,with significant differences.Reoperation rate in group A and group B was 0.62％ (1/162) and 4.48％ (6/134),respectively.Conclusion Sclerotic bone,multiple cavities,and bony bridges are parts of foci in spinal tuberculosis.Clearing tuberculous foci with sclerotic bone,multiple cavities,and bony bridges can increase the curative effect,shorten the time of chemotherapy and reduce the side effects of drug,thus early resumption can be achieved.

This study presented our experience in the treatment of testicular torsion, which may help achieve early diagnosis and improve therapeutic effects. A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011. The age of the patients ranged from 16 days to 34 years. All the patients had unilateral testicular torsion, which took place on the left side in 43 cases and on the right side in 28 cases. The course of the disease varied between three hours to 30 days. Post-operative follow-up was conducted until October 2011. Items examined included signs and symptoms at their first clinical visit, ultrasound findings, treatment in emergency surgery, and post-operative follow-up. In this study, the 71 patients were diagnosed with testicular torsion by color Doppler sonography, 7 had testicular fixation, 63 patients received orchiectomy, while 1 patient did not undergo surgery due to pressure from family members. Post-operative follow-up showed that the one patient's testicle, which had been reserved, atrophied, while all the other survived. No recurrence was found during the follow-up visits. It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion, and the diagnosis and treatment by the first attending clinician is of critical importance.

Objective To examine the levels of plasma tissue factor pathway inhibitor (TFPI) in patients with acute pancreatitis (AP) to assess the clinical value of diagnosis for severe acute pancreatitis ( SAP).Methods Sixty-eight patients were divided into mild acute pancreatitis (MAP)group (n=36) and SAP group (n=32), and twenty volunteers were chosen into normal group ( n=20 ) .Clinical data of these patients were collected, including APACHEⅡscore and Ranson score.Plasma levels of TFPI were measured by ELISA.Results The plasma levels of TFPI in SAP group, MAP group and control group were (4274.25 ±639.83),(3026.81 ±465.76) and (2468.73 ±262.39)pg/ml, respectively(P<0.05).There were significant positive correlations between TFPI and WBC, AST, ALT, TBIL, Cr, PT, APTT, PCT, APACHEⅡscore and Ranson score (P<0.05).The area under the curve (AUC) of TFPI for SAP was 0.902(95%CI=0.845 -0.959, P<0.05 ) .The cutoff value was 4028.83 pg/ml for plasma TFPI with a sensitivity of 87% and a specificity of 78%.Conclusion Plasma levels of TFPI in patients with SAP are significantly increased, which maybe help diagnose SAP.

OBJECTIVE: To evaluate the clinical outcomes of single-balloon kyphoplasty in the treatment of thoracic osteoporotic compression fractures via extrapedicular approach METHODS: From July 2004 to May 2008, 38 cases (52 vertebra) of thoracic osteoporotic fractures were treated by balloon kyphoplasty via unilateral extrapedicular approach, including 12 males and 26 females with an average age of 60.3 years (range 55-72 years). There were 34 cases of primary osteoporosis, and 4 had administrated hormone due to other diseases for over 6 months. Symptomatic levels ranged from T_4 to T_(12) confirmed by physical examination, MRI and X-ray. The pain relief, restoration of vertebral height and kyphosis correction were compared before and after operation by using visual analogue scale (VAS) and radiograph, respectively. In addition, bone cement leakage location and complications were recorded. RESULTS: Operation were successfully performed in 38 cases with an average injection of bone cement volume of (3.2+ 1.4) mL (2.25-4.60 mL in unilateral infusion). The mean time of surgery was 25-55 minutes, and that of follow-up was 9.5 months (6-24 months). Back pain of 36 cases was improved, and the VAS 3 days postoperatively and the final follow-up was significantly reduced (P < 0.05). The vertebral anterior margin and median height following surgery were significantly improved detected by X-ray (P < 0.05), and average median height restoration was (50.90+34.60)%, but no significant change was found in posterior height (P > 0.05). No lateral wedging or changes in the coronal alignment was found. Three cases (5 vertebra) had cement leakage: the bone cement of 1 case leaked to posterior margin through the puncture channel, and 2 cases leaked to lateral vertebra through vertebral venous system without any adverse event. The patients could move the second day after surgery, discharged from the hospital at days 3-4, and restored to normal life at 1 month postoperatively. No blood vessel or spinal cord puncture injury or pulmonary embolism, or blood vessel embolism was found. CONCLUSION: Unilateral extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic fractures. It rapidly releases backache, restores the body height of fractured thoracic vertebrae and improves quality of life of the patients.

This study presented our experience in the treatment of testicular torsion, which may help achieve early diagnosis and improve therapeutic effects. A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011. The age of the patients ranged from 16 days to 34 years. All the patients had unilateral testicular torsion, which took place on the left side in 43 cases and on the right side in 28 cases. The course of the disease varied between three hours to 30 days. Post-operative follow-up was conducted until October 2011. Items examined included signs and symptoms at their first clinical visit, ultrasound findings, treatment in emergency surgery, and post-operative follow-up. In this study, the 71 patients were diagnosed with testicular torsion by color Doppler sonography, 7 had testicular fixation, 63 patients received orchiectomy, while 1 patient did not undergo surgery due to pressure from family members. Post-operative follow-up showed that the one patient's testicle, which had been reserved, atrophied, while all the other survived. No recurrence was found during the follow-up visits. It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion, and the diagnosis and treatment by the first attending clinician is of critical importance.
Adolescent ; Adult ; Emergency Treatment ; methods ; Humans ; Male ; Postoperative Period ; Testis ; surgery ; Young Adult