ABSTRACT:Objective To investigate the clinical value and application indications of the second biopsy-cervical conization in the diagnosis and treatment of cervical lesions.Methods We selected 413 patients from Department of Gynecology and Obstetrics,General Hospital of Jinan Military Command,who received cervical multi-point biopsy pathology IA for cervical cancer and cervical conization (LEEP knife)of the second biopsy between January 2012 and October 2015.Their data were retrospectively analyzed.Results Compared with cervical multi-point biopsy, the second biopsy-cervical conization after operation had pathological upgrade in 10.65% (44/413),agreement in 73.37% (303/413),and reverse (pathological levels drop and overcast)in 15.98%(66/413).Cervical multi-point biopsy and the second biopsy-cervical conization significantly differed in the diagnosis of cervical low-level intraepithelial lesion,high-grade intraepithelial lesions,and early invasive cancer (IA)(T=21.740,v=3-1=2,P<0.05).Before conization high-risk type HPV infection positive rate was 71.91%(297/413);after operation it was 86.36% (38/44)in upgrade pathology and 70.20% (259/369)in non-upgrade one.And thin prep cytologic test (TCT)showed that the positive rate (ASC-US and above)was about 87.89% (363/413), of which about 11.85% (43/363)was pathological upgrade after conization.The positive rates of high-risk type HPV infection and TCT result (ASC-US and above)in cervical lesions differed significantly between pathological upgrade and non-upgrade after conization (χ2=5.092,P<0.05,χ2=4.476,P<0.05).Conclusion The second biopsy-cervical conization technique as a means of reevaluation of cervical pathological changes in diagnosis and treatment of cervical biopsy under colposcopy can significantly improve diagnosis rate,reduce misdiagnosis and occult cervical cancer,but its clinical application has some indications.

Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Objective To evaluate the radiofrequency ablation in treatment of primary and recurrent liver cancer and to explore the risk factors affecting prognosis.Methods 1 64 patients with primary and recurrent liver cancer underwent radiofrequency ablation treatment.The clinical data including liver function before and after treatment,alpha-fetoprotein (AFP),the rate of relapse and survivalwere retrospectively analyzed.The univariate Logistic regression analysis was used to analyzed the risk factors associated with the prognosis.Then the risk prognostic factors were analyzed using COX risk model.Results After treatment,AFP and liver function were significantly improved in patients (P<0.05);Complete tumor ablation rate was 87.50%.After cancer treatment 1,2,3,4 years,the recurrence rate was 17.9%,29.9%, 45.9% and 55.0% respectively.Conclusion Radiofrequency ablation is an effective treatment for primary liver cancer treatment,the risk factors affecting prognosis include tumor differentiation,tumor recurrence,TNM stage,AFP,intraoperative blood transfusion, surgical,cancer and surgical site before surgery transaminase levels.

OBJECTIVE:To establish a method for qualitative identification of Shenjin huoxue mixture.METHODS:Ly-copodii japonicum,Paeonia lactiflora,Dipsacus asperoides and Radix et Rhizoma Glycyrrhizae in the preparation were identified by TLC.RESULTS:At the corresponding positions,the color of TLC spots of Paeonia lactiflora,Dipsacus asperoides and Radix et Rhizoma Glycyrrhizae in the test samples and in reference substances were identical.There was no interference form negative control.But no characteristic spots of Lycopodii japonicum in the sample were noted.CONCLUSION:The established TLC identification method of Paeonia lactiflora,Dipsacus asperoides and Radix et Rhizoma Glycyrrhizae is reproducible,specific,reliable and suitable for the quality control of Shenjin huoxue mixture.The absence of characteristic TLC spots of Lycopodii japonicum in the sample is suggestive of the necessity of improving the production technology of Shenjin huoxue mixture.

DNT cells(CD4-CD8-double-negative T cells)ale newly discovered immune cells,whose surface ex press neither CD4 nor CD8 molecules.In recent years,the prognosis and survival quality of tumour patient have been greatly improved through cell immunotherapy.Immunocyte can kill the tumour directly Or through immunoregu lation.The study of DNT cells(double-nnegative T cell)on cancer cells will be of vital significance.

ObjectiveTo investigate the diagnostic value and prognostic significance of plasma soluble triggering receptor-1 on myeloid cells ( sTREM-1 ) in patients with sepsis in the early stage.MethodsA total of 56 patients with systemic inflammatory response syndrome (SIRS) were enrolled for prospective and control study from May 2009 through July 2010. According to the criteria of sepsis set by SCCN/ESICM/ACCP/ATS/SIS in 2001, patients were divided into sepsis group ( n = 32), SIRS group (n = 24) . Meanwhile, 25 non-SIRS patients were enrolled in the control group. The sepsis group was further divided into two subgroups, namely survival subgroup and non-survival subgroup according to 28-day outcomes. The sTREM-1, procalcitonin (PCT), C-reactive protein (CRP), white blood cell count and neutrophil percentage count (NPC) were measured and APACHE Ⅱ scores were determined within 24 hours after admission. The correlation between sTREM-1 and APACHE Ⅱ score was analyzed. Quantitative data were analyzed by using F-test or Kruskal-Wallis test. ResultsThe plasma level of sTREM-1 in patients of sepsis group was significantly higher than that in SIRS group and control group [215. 1 (157.9 ～397.3) ng/L vs 103.6 (89.4 ～ 176.2) ng/L vs 33.6 (26.2 ～ 43.0) ng/L, P＜0. 05]. The plasma level of sTREM-1 in non-survival group was significantly higher than that in survival group[360.5 (262.2～434.5) ng/L vs 204. 1 (175.0～269.6) ng/L, P=0.002]. In sepsis group, the plasma level of sTREM-1 was positively correlated with APACHE Ⅱ score ( r, = 0. 426, P = 0. 032 ) The area under the ROC curve of sTREM-1 was 0. 935, larger than that of PCT and CRP. Conclusions Plasma sTREM-1 is a useful marker in diagnosis of sepsis at early stage. The increase in the level of sTREM-1 during the first 24 hours might be correlated with poor outcome of patients with sepsis.

The larval and adult schistosomes can effectively establish the stable parasitic relationship with their final hosts and then maintain the parasitism for a long time,due to the successful adaptation to their parasitic lifestyle. This paper reviews the progress of research on parasitic adaptability of schistosomes in several respects,and demonstrates the application value of schisto-somal genes related to parasitic adaptability in schistosomiasis control and exploitation of natural active molecules.

Objective To observe clinical efficacy of recombinant human erythropoietin(rhu-EPO)in sepsis with anemia.Method From June 2005 to December 2006,sixty sepsis with anemia patients in the Second Affiliated Hospital of Tianjin Medical University were divided into control group(n=30)and theatment with rhu-EPO group(n=30).The exclusion criteria was:renal imufficiency patients needing blood purification,patients with hemorrhage of digestive tract,and patients who used rhu-EPO before.Patients in the rhu-EPO group were hypodermically injected with rhu-EPO at 48 hours after admission,6000 units par time,and continued every other day for two weeks.When the hemoglobin Was lower than 80 g/L,patients received red blood cell(RBC)transfusion or received other treatment decided by doctor.The data were expressed as(x±s),and were analyzed using Student's t test and Fisher's exact test with SPSS 11.5.A P valLie less than 0.05 indicated statistical significance.Results There Was no significant difference on hemoglobin between the two groups before treatment (P＞0.05).After treatment,the hemoglobin of patients in rhu-EPO group was higher than that in control group [(105.87±11.48)g/L vs.(91.23 ±19.89)g/L,P＜0.01].The units of RBC transfusions was less in patients of rhu-EPO group compared with control group[(2.0 ±0.47)U vs.(2.63±0.43)U,P＜0.01].There was no significant difference on mortality between two groups(P＞0.05).Conclusions In sepsis with anemia patients,administration of rhu-EPO every other day can increase red blood cell level and reduce RBC transfusion.

Population pharmacokinetics(PPK),which is based on the principle of statistics,can be used to estimate various inter- and intra-individual factors which affect pharmacokinetics.By using Bayesian estimator,PPK can predict individual pharmacokinetic parameters accurately.PPK is widely used in the immunosuppressive therapy with cyclosporine,tacrolimus,mycophenolic acid and sirolimus.

Recent research has revealed that scorpion venom contains short-chain peptides with the specificity on K+or C1-channels, in addition to the knowledge of many kinds of long-chain peptides with the specificity on Na+ channels. According to the similarity of molecular structure and/or function, they have been classified into several groups. These short-chain scorpion peptides are playing more and more important role in studying the structure and function of K+ or C1- channels. The advance of structure and function of short-chain scorpion peptides in recent years was briefly introduced.