Objective To find out the classification of diseases contracted by patients of the emergency department.Methods A retrospective investigation and analysis was made of the medical records of 82 598 emergency cases in our hospital. Results Injury and poisoning, respiratory disease, and disease of digestive system were the first three kinds of disease treated by the emergency department; male emergency cases outnumbered female ones; the volume and visiting hours of emergency cases in a typical day take the shape of humps, with 19 to 21 hours being the climax; the ages of emergency cases averaged 41.5, with patients of the age group running from 19 to 35 being the largest in number in 16 kinds of disease. Conclusion ①It is imperative to determine the priorities of technology construction and the orientation of talent cultivation in the emergency department according to the disease spectrum of emergency cases. ②It is necessary to attach importance to the education of males in health, safely and precautions. ③It is essential to fully recognize the great significance that enhancement of the expertise of the emergency department carries with regard to the health of the population. ④It is important to rationally plan work in accordance with the rush hours of emergency cases's visits.

Objective To compare the efficacy of liposuction and open surgery for patients with accessory breast.MethodsA total of 73 patients with accessory breast,who were treated in our hospital from June 2000 to December 2007,were enrolled in this study and divided into open surgery(June 2000 to June 2004,43 patients with accessory breast at 80 sides)and liposuction(April 2004 to December 2007,30 cases with accessory breast at 58 sides)groups.The outcomes of the patients,operation time,and intraoperative blood loss in the two groups were compared.Results The curative rate of the both groups were 100%.However,the open surgery group had more blood loss [(49.6?13.3)ml vs(28.9?6.9)ml,t=10.836,P=0.000] and longer operation time[(57.4?11.1)min vs(27.3?4.3)min,t=19.597,P=0.000].Conclusions Compared with open surgery,liposuction leads to quicker recovery and less trauma without leaving scars,and thus is more acceptable to the patients.

Paraneoplastic pemphigus(PNP) is a clinically, histologically, and immunopathologically distinct autoimmune bullous disease characterized by severe painful mucosal erosions and polymorphous skin lesions. Histopathology shows acantholysis with lichenoid dermatitis or keratinocyte necrosis, and there are autoantibodies to various epidermal proteins with underlying neoplasia. We report two cases of paraneoplastic pemphigus in China firstly. The clinical, histologic, and immunopathologic findings of both cases strongly suggest the diagnosis of paraneoplastic pemphigus associated with Castleman′ s tumor.

Objective To investigate the influence of different diluents(physiologic saline, dis-tilled water and human inactivated serum) on measurement of 15 items of biochemical parameters.Methods Fifteen items of biochemical parameters [alanine transaminase(ALT), aspartic transaminase (AST), alkaline phosphatase( ALP), gamma glutamyl transpeptidase ( GGT), creatine kinase ( CK),lactate dehydrogenase(LD), hydroxybutyrate dehydrogenase(HBDH), total bilirubin(TBIL), direct bilirubin(DBIL), total bile acid(TBA), ereatinine(Cr), uric acid(UA), eholesterol(CHO), glucose (GLU), and blood urea nitrogen(BUN)] were chosen. For each parameter, 45 serum samples with different eoncentrations of the parameter were collected. After diluted with different diluents(physio-logic saline, distilled water or human inactivated serum), the serum samples were detected by applying the fully automated biochemical analyzer. The mean value was calculated and statistical analysis was performed. Results There were some differences of detection results when the specimens were diluted with different diluents. ALT, AST, GGT, DBIL, and HBDH serum samples could be diluted by 10 times with physiologic saline, distilled water or human inactivated serums ALP and TBA serum sam-ples could only be diluted with inactivated serum, otherwise its result would be lower; GLU, TBIL samples could be diluted with distilled water and inactivated serums for BUN, CR, UA, CK, LDH,and CHO samples, physiologic saline or human inactivated serum might be optimal; if distilled water was chosen, the results of other parameters tented to decline except UA. It was BUN was improper to dilute the BUN samples with distilled water. In addition, there was no significant difference between the items diluted by 5 times and 10 times with physiologic saline. All the 15 items could be diluted with inactivated serum. Conclusion The inactivated serum should be the first choice of diluents to e-nure the accurate results of biochemical parameters. If the prepared inactivated serum is absent, we may choose other diluents according to the above-mentioned results.

ObjectiveTo investigate the value for the clinical application of urokinase combined with Sodium Tanshion ⅡA in the treatment of cerebral thrombosis.Methods160 cases with cerebral thrombosis in our hospital were chosen.They were randomly divided into A group with 80 cases and B group with 80 cases.A group was the observation group (Tanshion ⅡA Urokinase combined treatment group),B group was the control group (urine kinase treatment group).2 weeks treatment was a course.The efficacy of treatment in the two groups at the end was taken for statistical analysis.ResultsThe neurological deficits were significantly improved in A and B group before and after treatment (P ＜ 0.05,there was statistically significant).The neurological deficit scores in A group after treatment was significantly lower than group B ( P ＜ 0.05,there was statistically significant).The total effective rate was 95 ％ by the treatment of urokinase and Tanshion Ⅱa in A group which was higher than group B ( P ＜ 0.05,there was statistically significant difference).ConclusionThe treatment of urokinase combined with Sodium Tanshion Ⅱa could improve neurological deficits and improve the clinical therapeutic effect.

Objective To investigate the clinical distribution and antibiotic resistance of the nonfermenting bacterial strains isolated in Beijing Anzhen Hospital from 2008 to 2012.Methods The bacteria were identified by VITEK-compact system and Phoenix 100 system. Antimicrobial susceptibiity was tested by dilution method. Results A total of 2 450 strains of nonfermentative gram-negative bacteria were isolated from clinical specimens. Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia accounted for 57.2%,25.5% and 10.0%.Specimens were mostly collected from respiratory tract (80.9%),followed by blood (8.1%)and wound exudates (3.9%).The strains were mainly collectd from ICU (50.0%),cardiac surgery ward (17.0%)and respiratory medical ward (11.5%).The prevalence of imipenem-resistant A.baumannii was 62.3%,79.2%,70.4%,76.1%,67.8% from 2008 to 2012.The prevalence of imipenem-resistant P.aeruginosa was 28.7%,25.0%,27.6%,31.1% and 32.0%.S.maltophilia strains showed the highest susceptibility to trimethoprim-sulfamethoxazole and levofloxacin.Conclusions The high prevalence of antibiotic-resistant non-fermenting bacteria poses a great challenge to clinicins. The rational treatment choice should be based on the result of suseptibility testing.

Objective To clone human neuron-specific enolase (NSE)gene and prepare the monoclonal antibodies against human neuron-specific enolase and to test the expression of NSE in tumor cell lines by immunocytochemistry (ICC).Methods The gene fragment of human NSE was amplified by RT-PCR and ligated to the pGEM vector. After the sequencing of recombinant NSE, it was ligated to the expression vector pMS-31b. The MS2-NSE fusion protein was expressed after higher temperature induction. The purified target protein was used for immunizing BALB/C mice to prepare McAbs against NSE.Results Full length of NSE gene with 1 305 bp was cloned. Molecular weight of MS2-NSE was 57 000. 1.42 mg/L of MS2-NSE fusion protein could be expressed. Two strains of hybridoma secreting NSE McAbs were obtained by ELISA screening. The subtypes of the NSE McAbs were IgG1and IgG2a. The two McAbs could react with A549 cell lines in ICC. NSE positive staining in ICC was mainly located in cytoplasm.Conclusions We clone human neuron-specific enolase gene, obtain the anti-NSE monoclonal antibodies and examine the expression of NSE in lung cancer tumor cell line.

Objective To investigate the clinical features,pathogenic distribution and drug susceptibility of patients with infective endocarditis (IE).Methods Clinical data of IE patients were collected,who were admitted to Capital Medical University Affiliated Beijing Anzhen Hospital from January 2012 to March 2015.Results Three hundred and three IE patients were enrolled with age of (43 ± 16)years old.Fever (85.5％)and cardiac murmur (62.4％)were the most common clinical presentations.Congenital heart diseases was the leading underlying diseases in IE patients.Non rheumatic valve diseases (13.5％) followed.Vegetations were found in 90.4％ (274/303) patients.Streptococcus which accounted for 44.2％ was the major pathogen of IE.Staphylococcus (28.9％) was the second common pathogen.Gramnegative bacteria were diversified in categories.Gram-positive cocci were consistently sensitive to vancomycin and linezolid.Conclusions Congenital heart disease is the main underlying disease related to IE.Streptococcus is still the primary pathogen.Gram-positive cocci keep good sensitivity to vancomycin and linezolid.

ObjectiveTo observe the efficacy of L-carnitine in prevention and treatment of toxicity of LFP chemotherapy with gastrointestinal cancer. Methods60 cases of gastrointestinal cancer were divided into 2 groups according to the admission date. The treatment groups received LFP chemotherapy and L-carnitine, while the control group received LFP chemotherapy alone.Both groups received 3 cycles chemotherapy. The gastrointestinal toxicity, neurotoxicity, hematologic toxicity and physical state were compared.ResultsThere were 12 cases of peripheral neurotoxicity in treatment group,the incidence rate was 40.0 ％;but in control group there were 21 patients, and the incidence rate was 70.0 ％. There was a significant difference between the two groups(x2=5.4545,P =0.0195). Anemia in the treatment group was 56.7 ％ (17/30); in the control group the rate was 86.7 ％ (26/30).There was a significant difference between the two groups (x2 =6.698,P =0.0351).After chemotherapy,in the treatment group,there were 4 cases with increasing Karnofsky score ≥ 10,19 patients whose Karnofsky score did not change,and 7 cases with reduced Karnofsky score ≥ 10; in the control group,there was 1 case with increasing Karnofsky score ≥ 10,13 cases with Karnofsky score no changing,and 16 cases with reduced Karnofsky score ≥ 10.The changes in physical state of two groups had a significant difference(x2 =5.711,P =0.0169).The gastrointestinal toxicity,thrombocytopenia,and neutropenia of two groups had no significant difference.ConclusionL-carnitine can reduce peripheral neurotoxicity and hematologic toxicity,improve the patient's physical state in patients received LFP chemotherapy.

Objective To investigate the roles of a variety of cytokines including transforming growth factor beta (TGF-β),interleukin-6 (IL-6) and interleukin-2 (IL-2) in the differentiation of CD+4 Tlymphocyte cells.Methods T lymphocyte cells either in human peripheral blood or routine spleen were cultured in vitro under different stimulation conditions.Flow cytometry was used to analyze the percentages of CD+4IL-17+ T-helper 17(Th17) cells,CD+8 IL-17+ T cells,CD+4 CD+25 FOXP+3 T regulatory (Treg) cells among activated T cells.Results Differentiation of Treg cells,Th17 cells and CD+8 IL-17+ T lymphocyte cells was enhanced when murine splenic T cells were cultured with TGF-β.The levels of expression were (7.8±2.2)%,(12.6±3.1)%,(10.1±2.6)% ,respectively.Experimental control group was severally same type of T cells without cytokine treatment.The levels of expression were (4.8±0.6) %,(1.7±0.5) %,(1.0±0.4) %,respectively.There were statistically significant differences among them (q=4.09,8.80,9.61.P<0.05 or P<0.01).Under combination treatment with IL-6 and TGF-β,(17.8±5.3) % Th17 cells and (15.0±4.2)% CDCD+8 IL-17CD+ T cells were induced,whereas the levels of Treg cells whose differentiation were restrained were (4.1±1.2) %.The differences were statistically significant compared with the level of same type of T cells in TGF-β group (q=5.03,5.17,5.04,P<0.01).Moreover,combination treatment with IL-2 and TGF-β decreased percentages of Th17 and CDCD+8 IL-17CD+ T cells and increased percentages of Treg cells in T cell population.There was an opposite effect when anti-IL-2 was apphed.The percentages of Th17 and CD+8 IL-17+ T cells were increased and the percentages of Treg cells were reduced The regulation trend of T lymphocyte cells in human peripheral blood was similar with those in routine spleen.Conclusion Various cytokines are of great importance in the regulation of the balance between Th17 and Treg cell.