Child ; Humans ; Orthostatic Intolerance

Objective To calculate the measurement uncertainty of clinical chemical analytes according to the internal quality control (IQC)and external quality assessment (EQA)data in clinical laboratory.Methods Collected the IQC data from January to June 2013 and EQA data between 2012~2014 of clinical chemistry in clinical laboratory.Calculated the measure-ment uncertainty and extended uncertainty according to the Nordtest criteria.Results It was effective to evaluate the uncer-tainty using IQC and EQA data.ALP ranked the highest extended uncertainty and Na+ ranked the lowest uncertainty.The range of uncertainty varies greatly,electrolyte 4.27~18.16,enzyme 8.12~24.88,small molecular 4.88~12.44,protein and lipids 4.78~13.1.Conclusion The evaluation of clinical chemistry uncertainty by IQC and EQA data is simple and practi-cal,which is beneficial for assurancing the measurement accuracy.

Objective To investigate the expression and distribution of COX-2 in benign and malignant breast disease,and the relationship among COX-2 expression and the clinicopathologic factors,hormone receptors.Methods Immunohistochemistry Was used to investigate the expression and distribution of COX-2 in 8 accessory.breasts,31 BPBDs(15 in adnosis,16 in fibroadnoma),70 IDCs(35 of them accompany with DCIS);The relationships between the expression of COX-2 and hormone receptor(ER and PR),C-erbB-2.and the clinicopathologic factors were studied respectively.Results①The expression of COX-2 in various kinds mammary diseases:8 accessory breasts were all negative;the positive rate of COX-2 in BPBD was 96.5%(30/31),among these,the positive rate of COX-2 in adnosis was 93.3%(14/15),and in fibroadnonm was 100%(16/16).The positive rate of COX-2 in DCIS was 85.7%(30/35).The intensity of COX-2 expression in DCIS of periph-IDC was higher than that in corresponding carcinoma.The positive rate of COX-2 in IDC Was 84.3%(59/70),the expression of COX-2 Was different among non-cancer gland.②COX-2 expression in BPBD was obviously higher compared with COX-2 in IDC,the difference was significant in statistics(χ2=9.39,P＜0.025).③The expression of COX-2 in DCIS was correlative with low histological differentiation(χ2=10.98,P＜0.005),PR negative(P=0.019,Fisher exact probability),and C-erbB-2 positive(P=0.0008,Fisher exact probability).The expression of COX-2 in IDC was correlative with lymph node metastasis(χ2=4.09,P＜0.05),tissue poorly differentiated(P=0.004,Fisher exact probability),PR negative(χ2=6.91,P＜0.01)and C-erbB-2 positive(χ2=5.94,P＜0.025).Conclusion COX-2 does not express in normal mammary gland.It is high-expressed in BPBD,DCIS and IDC;These indicate the up-regulation of COX-2 expression not only participates in breast carcinogenesis,but also promotes its metastasis and progression,and suggests COX-2 may down-regulate reactivity of endocrine thempy by participating in therapy resistance of PR negative breast cancer.

With the increasingly aging population,osteoporosis morbidity had been gradually increased and the incidence of the hips and vertebral fractures showed a trend of rapid growth,which brought great pain and economic burden to patients and society.There were a variety of anti-osteoporosis drugs clinically,which interfere with the development of osteoporosis via multi-approaches to reduce the clinical symptoms and improve their quality of life.In this paper,the author aimed to make a review of the research progress of anti-osteoporosis drug clinical application.

Objective To investigate spiral CT,PET/CT and clinical manifestations in non-HIV infectious penicilliposis marneffei lung disease, to improve diagnostic level of this disease.Methods Imaging manifestations of 6 cases of non-HIV infectious penicilliposis marneffei confirmed by bronchofiberscope lung biopsy and/or pus culture were analyzed retrospectively All cases underwent chest CT,two had brain MRI,and two had PET/CT scan before treatment.Imaging appearances were observed and combined with clinical dates and literatures.Results Unilateral lung lesion was detected in 1 case,bilateral lungs lesions in 5 cases.Multiple patchy consolidation,stripe shadow in bilateral lungs or right lung were found in 3 cases, multiple nodes in 2 cases, mass with nodes in 1 case.Among 6 cases, 2 had septa interlobulare thickness,1 had tracheal fistula,2 had pericardium and pleura involvement,4 had bone destruction,1 had the brainand liver involvement.6 cases showed multiple lymphadenectasis,amalgamation and necrosis in bilateral hilar,mediastinaand the neck.2 had abdominal cavity and or retroperitoneal lymphadenectasis.On PET/CT,2 cases showed high uptake,and the range of SUV value were 1.4-13.9.Initial misdiagnosis by imaging was found in 5 cases.6 patients recovered after anti fungus treatment.Conclusion Imaging appearances of non-HIV infectious penicilliposis marneffei mainly reveals as multiple patchy consolidation,nodes and mass in bilateral lungs, all accompany with lymphadenectasis, many with bone destruction,lack of specificity, which needs lesion biopsy and pus culture to make confirmed diagnosis.

Objective To evaluate the early outcomes of mini-open lumbar microdiscectomy. Methods There were 38 cases in each group of mini-open lumbar mierodiscectomy and conventional discecto- my.Operating time,blood loss,time of leaving the bed and length of hospital stay were compared in two groups.MacNab criteria were used to evaluate the outcomes.Results To compare the conventional discec- tomy group,microdiscectomy group spent similar operating time,but had less blood loss(P

ATP-Binding Cassette Transporters ; metabolism ; Adenosine ; analogs & derivatives ; therapeutic use ; Animals ; Antineoplastic Agents ; therapeutic use ; Biomarkers, Tumor ; analysis ; Cell Differentiation ; Diketopiperazines ; Heterocyclic Compounds, 4 or More Rings ; Humans ; Neoplasms ; drug therapy ; pathology ; Neoplastic Stem Cells ; cytology ; metabolism ; Protein Kinase Inhibitors ; therapeutic use ; Pyrimidinones ; therapeutic use ; Quinazolines ; therapeutic use ; Signal Transduction ; Triazines ; therapeutic use ; Wnt Proteins ; metabolism

Objective To observe the changes of respiratory musc]e strength by traditional Chinese medicine combined with cholinesterase inhibitors in myasthenia gravis (MG) patients.Methods Thirty-four cholinesterase inhibitor-resistant patients,of them 14 were MG patients with stage Ⅰ ,and 20 were stage Ⅱ ,were treated with bromide dimethylcarbamate ( 360-480 mg/d ).Traditional Chinese potion were administered in those without effectiveness,and the dosages of bromide dimethylcarbamate decreased with Traditional Chinese potion lasting for 4-6 months.Vital capacity ( VC ),maximal voluntary ventilation ( MVV ),maximal inspiratory pressure ( PIM ),maximal expiratory pressure ( PEM ),respiratory centre driving pressure ( P0.1 ),residual volume ( RV )were measured before and after treatment.Results The amelioration of VC,MVV,PIM,PEM,P0.1 ,RV,respiratory muscle strength and other indicators of 34 MG patients were not obviously after treatment with cholinesterase inhibitor alone ( P ＞ 0.05 ).After treatment with traditional Chinese medicine combined with cholinesterase inhibitors,VC,MVV,PIM,PEM ( before treatment:76.66% ± 18.59%,68.03 % ± 10.45 %,43.25 % ± 18.16%,21.75 % ±14.44% ) increased significantly in all 34 MG patients( after treatment:86.91% ± 14.87% ,75.11% ± 11.17%,52.66% ±20.32% ,28.56% ± 10.06% ) ( P ＜ 0.05).RV decreased from 164.94% ± 67.97% to 143.16% ±79.21% (P ＜0.01 ),and respiratory muscle strength,endurance and other indicators significantly improved (P ＜0.01).PIM(65.80% ±28.03% to 52.66% ±20.32%),and PEM (37.03% ±20.57% to 28.56% ±10.06%)improved more significantly in group stage than in group stage (P ＜0.01 ).Respiratory muscle endurance in stage Ⅰpatients ( 108.71% ± 17.56% ) improved significantly than stage Ⅱ patients (96.01% ± 14.12% ,P ＜ 0.01 ).Conclusions Traditional Chinese medicine combined with cholinesterase inhibitors could effectively improve the lung function and respiratory muscle strength in patients with resistance of the cholinesterase inhibitors.The improvement of lung function,respiratory muscle strength were more obviously in stage Ⅰ patients than in stage Ⅱ patients.Respiratory muscle strength and endurance were improved greater in stage Ⅱ than in stage Ⅰ patients.

Objective To observe the clinical effect of percutaneous transluminal angioplasty (PTA)combined with autologous peripheral blood stem cells(PBSC)transplantation in the treatment of lower extremity ischemic disorders.Methods Fourty-two cases of lower extremity ischemic disorders in the treatment group were treated with PTA and autologous peripheral blood stem cells injection and 40 cases in control group were treated with PTA exclusively.Results All the procedures were successful.In treatment group,ABI improved from 0.32 ±0.11 to(at the 3rd month)and 0.49 ±0.13(at the 6th month)(t=-6.765,-6.040,P＜0.05)while TcPO_2 improved from(26.1 ± 2.3)mm Hg to(32.7 ±4.2)mm Hg(at the 3rd month)and(34.5 ±2.7)mm Hg(at the 6th month)(t=-8.901,-14.250,P＜0.05).In control group,ABI improved from 0.30 ±0.12 to 0.47 ±0.15 and 0.47 ±0.130=-5.631,-5.873,P＜0.05)while TcPO_2 increased from(25.9 ±2.4)mm Hg to(28.9 ±2.9)mm Hg(at the 3rd month)and(28.9 ± 2.1)mm Hg(at the 6th month)(t=-5.090,-5.389,P＜0.05).There was significant difference in TcPO_2 on follow-up between the two groups after the treatment(P＜0.05).Conclusion Autologous PBSC transplantation in combination of PTA was effective for the treatment of lower extremity ischemic disorders.PBSC injection helps to increase TcPO_2.

From January 2005 to January 2008, 23 cases of fractures and dislocations of cervical spine treated with anterior decompression, reconstruction of bone graft with titanium mesh, and titanium locking plates fixation in Department of Orthopaedics, the 309 Hospital of Chinese PLA were retrospectively analyzed, including 16 males and 7 females, aged 41.9 years (ranging 25 ?65 years). The clinical effect and application value of this treatment was evaluated; the conditions at preoperative, immediate postoperative and follow-up were evaluated by JOA grade, and these radiographs were taken. Lordosis (kyphosis) of the fusion segment with Cobb's angle, and lordosis (kyphosis) of cervical spine with D value were measured to evaluate effect of reconstruction and cervical spine physiological curve. All cases were followed-up for 20.5 months (ranging 1-3 years). Clinical stability was reached in all cases during the follow-up. There were significant differences between preoperative and immediate postoperative, between preoperative and follow-up groups in terms of JOA grade, Cobb's angle and D value (P < 0.05). The JOA grade of immediate postoperative was improved compared with that during follow-up (P < 0.05). The mean improvement rate was 63% at 1 year of follow up. A good curative effect was obtained by using anterior locking plate with titanium mesh systems in treatment of cervical fractures and dislocations and a good effect of restoring and maintaining the lordosis of cervical spine can be also obtained.