Objective To quantitatively evaluate relative contribution of medical history,physical examination and laboratory investigation to diagnoses for medical outpatients.Methods In total,145 medical visitors to the outpatient department of Peking Union Medical College Hospital (PUMCH) during October 10 to 16,2008 were recruited and followed-up for 12 months.Results Nineteen of 145 visitors (13.1%) were lost during the period of follow-up and diagnoses were established for 86 of them (68.3%)finally with medical history and for 20 (15.9%) with physical examination or laboratory investigation,respectively.Confidence index of internists in their correct diagnosis increased to 7.3 with medical history and to 7.9 and 8.7 with physical examination and laboratory investigation in average,respectively.Conclusions Most visitors to internal medicine department could be diagnosed correctly with medical history only.On the basis of physical diagnosis,selection of adequate laboratory investigation for them is critical to improvement of clinical diagnosis.

Objective To investigate the effects of remote preconditioning on inflammatory cytokines and respiratory index of rabbit lung injured by ischemia/reperfusion.Methods Eighteen rabbits were randomly divided into three groups(6 each):control group(C),ischemia-reperfusion group(I/R)and remote preconditioning group(R).The plasma concentrations of interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)and interleukin-10(IL-10)were measured before ischemia and 60,120 and 180 min after reperfusion.Respiratory index(A-aO2/PaO2)was calculated before ischemia and 15,30,60,120 and 180 min after reperfusion.The animals were sacrificed after reperfusion,and the left lung was removed for calculation of wet/dry(W/D)ratio and lung permeability index,histological examination was done with light microscope,and diffuse alveolar damage(DAD)scores was estimated.Results The plasma concentrations of IL-6 and TNF-? were significantly higher in I/R group than in C group(P

Objective To investigate the effect of liver detoxification soup combined with compound glycyrrhizin on hepatitis-related factors in patients with chronic hepatitis B.MethodsFrom April 2014 to August 2015, 86 patients with chronic hepatitis B were enrolled in this study.Random number table was divided into observation group and control group (43 cases).The control group was given routine glycyrrhizin and other conventional (ALT), serum total bilirubin (TBil), serum albumin transferase (ALT) and serum total bilirubin (TBil) were measured before and after treatment.(HA), laminin (LN), type Ⅳ collagen (Ⅳ-C) and type Ⅲ procollagen (PCⅢ) were used to analyze the effect of hepatic fibrosis, And observe adverse reactions.ResultsThe effective rate of the observation group was 93.02% higher than that of the control group (76.74%, P<0.05).After treatment, the patients were treated with chest discomfort, emotional depression, epigastric fullness, fatigue, ALT (35.28±1.35) U/L, HA (165.25±1.44) mg/L, and the treatment group (P<0.05).After treatment, the levels of TBil (30.34±1.59)μmol/L, Alb (48.32±1.33)g/L, and the level of serum was significantly higher than that of the control group (P<0.01).The incidence of adverse reactions was 11.63% and 6.98% in the two groups.ConclusionTraditional Chinese medicine hepatectomy decoction combined with compound glycyrrhizin can effectively treat chronic hepatitis B and improve the level of serum hepatitis-related factors, and the adverse reaction is light, it is worthy of clinical application.

Many proteins from mushrooms can be used as potential antiviral agents and in plant protection.An antiviral protein,designated as y3,Was isolated from fruiting bodies of the fungus Coprinus comatus by fastflow ion-exchange column chromatography coupled with high-resolution molecular sieve chromatography.This glycoprotein was detected in both fruiting body and mycelium by Western blot analysis.According to its Nterminal sequence.an amino acid sequence and a partial cDNA sequence of the y3 gene were obtained.Protein y3 at 2.0μg/ml achieved 50.0% inhibition of tobacco mosaic virus(TMV,20μg/ml)lesions in Nicotiana glutinosa leaves.It also inhibited multiplication of TMV in Nicotiana tabacum Var.K326.

Objective To investigate the clinical skill and experience of laparoscopic herniorrhaphy in the treatment of abdominal hernia. Methods Clinical data of 30 cases of abdominal hernia undergoing laparoscopic her-niorrhaphy in Shengjing Hospital from May 2004 to December 2008 were analyzed retrospectively. There were 23 in-guinal hernia,4 incision hernia and 3 hiatal hernia. TEP in 20 cases,TAPP in 3 cases,lPOM in 4 cases and Nissen hiatal hernia repair in 3 cases were performed. Results The mean operating duration was 72 min for TEP, 127 for TAPP,150 min for IPOM,and ]60 min for hiatal hernia repair and the mean time for hospitalization was 4.6,5.8, 7.5, and 5.3 days. No conversion to open surgery happened among these cases. No recurrence was found. Conclu-sions Laparoscopic herniorrhaphy appears to be an effective and convenient technique for the treatment of abdomi-nal hernia and has many advantages of minimally invasive surgery.

Objective To evaluate diagnostic accuracy based on patient history and physical examinations in medical outpatients.Methods Totally, 145 consecutive patients visiting general internal medicine clinic at a university-affiliated teaching hospital during October 10 to 17, 2008 were recruited into the study and followed-up for 12 months.Results Eighteen of 145 patients ( 12.4% ) were lost to followup.Diagnosis was confirmed by follow-up for 45 ( 35.4% ) of those with medically unexplained symptoms (MUS).Sensitivity of physical diagnosis for those with MUS was 82.2 percent, with specificity of 95.1 percent, likelihood ratios of positive and negative results of 16.9 percent and 0.19 percent, its positive and negative prediction values of 90.2 percent and 90.7 percent, and overall accuracy of 90.6 percent,respectively.Conclusions MUS was common in medical clinical practice.Preliminary diagnosis for MUS based on patient history and physical examinations has been proved remarkably reliable.Carefully selected auxiliary laboratory evaluation combined with physical diagnosis is important for management of MUS.

Objective To investigate the sniff nasal inspiratory pressure (SNIP) of Chinese boys. Methods 299 healthy boys aged 5-12 years were measured with SNIP. Their height, weight, and age were recorded. Results The SNIP averaged (76.9±22.6) cmH2O, and was (59.1±14.2) cmH2O, (76.9±19.5) cmH2O, (85.3±23.5) cmH2O and (83.0±22.6) cmH2O in the boys of 5-6 years old, 7-8 years old, 9-10 years old and 11-12 years old, respectively. It was significantly different among boys of 5-6 years old, 7-8 years old and 9-10 years old (P<0.05), but no significant difference between 9-10 years old and 11-12 years old (P=0.55). Regression analysis indicated significant relations of SNIP with age, height, weight and Body Mass Index (P<0.01). Conclusion The SNIP of Chinese healthy boys are different from abroad. It is necessary to establish the Chinese children SNIP reference range.

Objective To investigate the protective effect of methylene blue (MB) on blood-brain barrier (BBB) injury after focal cere-bral ischemia-reperfusion in rats. Methods 18 male Sprague-Dawley rats were randomly divided into sham-operated group (n=6), model group (n=6) and MB treatment group (n=6). The left middle cerebral arteries were occluded for 1 hour and reperfused. MB was infused intra-venously immediately after reperfusion (3 mg/kg) and again 2 hours post-reperfusion (1.5 mg/kg), while normal saline was administered in the model group. The sham-operated group was treated as same as the model group without occlusion and infusion. HE staining was used to observe the histological injury in the cortex around the infarcted region 47 hours after reperfusion, while albumin immunohistochemistry was used to evaluate the permeability of the BBB, and immunohistochemistry and double immunofluorescence staining were used to exam-ine the expressions of glial fibrillary acidic protein (GFAP) and aquaporin-4 (AQP-4). Results HE staining showed that cells and blood ves-sels were not intact in the cortex around the infarcted region in the model group and they were better in the MB treatment group. The expres-sions of the albumin, GFAP and AQP-4 were higher in the model group than in the sham-operated group (P<0.01), and were lower in MB treatment group than in the model group (P<0.05). The double immunofluorescence staining showed the colocalization of GFAP and AQP-4 in the astrocytes. Conclusion MB may ameliorate the BBB disruption induced by focal cerebral ischemia-reperfusion through reducing glio-cyte proliferation and down-regulation of AQP-4 expression in rats.