Objective To compare the results of three methods for measuring C reaction protein.Methods 100 patients were collected from our hospital,and three different methods for measuring C reaction protein were used to analyze the level of C reaction protein.Results Correlation analysis showed that the correlation between immunoturbidimetric assay and immunochromatography was higher.The differences of three methods assayed the C reaction protein were significant (P <0.05 )among normal people by the variance analysis,but had not statistical significance among abnormal people (P >0.05).The differences among all of test peo-ple were significant(P <0.05).Conclusion Detection of C reaction protein was important for diagnose inflammatory diseases.

Objective To evaluate the diagnosis, treatment and prognosis of occult breast cancer(OBC). Methods Clinical data of 12 OBC cases from June 1995 to June 2006 were retrospectively analyzed.Results There were 12 female; the mean age was 52.7 years(39～66). Tumor of all cases was in one of breasts, left(10 cases) or right(2 cases), 4 cases in pro- menostasis, 8 cases in post-menopause, and inci-dence of OBC in all kinds of breast cancer was 0.5% (12/2385). All cases were found because of lump in axillary fossa, the biopsy of 10 showed cases were lymph node adenocarcinoma metastatic, the fine needle aspiration of 2 cases were lymph node adenocarcinoma metastatic. Three cases were positive in the determi-nation of estrogen receptor of lymph node adenocareinoma metastatic. Two cases, suspecting breast cancer,could be found fine calcification in the examination of breast X-ray molybdenum target in 10 cases. Buhra-sound in 11 cases and near infrared ray scan in 10 cases did not detect cancer in breast; chest X-ray and Bultrasound in 10 cases and CT and all over the body bone scan in 5 cases did not found any cancer besides breast. Ten cases used modified radical mastectomy for breast cancer, one case radical mastectomy for breast cancer, one palliative operation. Pathological diagnosis of 9 cases after operation found breast primary le-sion, 6 cases were infiltrated duct cancer, 3 eases were intraductal cancer. All cases received radiotherapy and chemotherapy. Three cases which were positive in the determination of estrogen receptor of lymph node adenocarcinoma metastatic received TAM. Followed-up was made from 3 to 10 years, 11 cases were not found recurrence or metastses, and 5 cases had been living over 5 years. Conclusions OBC is one of rare special breast cancers. The powerful infiltrating capability leads to lump in axillary fessa in prophase and dis-rant metastses. The biopsy and fine needle aspiration would be used for diagnosis. Modified radical mastecto-my for breast cancer is the usual therapy method.

Aged ; Aged, 80 and over ; Anthracosis ; complications ; microbiology ; Cerebral Infarction ; etiology ; Cross Infection ; complications ; Humans ; Male ; Middle Aged ; Pneumonia ; complications

Objective To evaluate the clinic efficacy of sufentanil and remifentanil by target- controlled infusion (TCI) combined with propofol in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixty patients,ASA Ⅰ ～ Ⅱ,undergoing elective EBUS-TBNA were randomly divided into group S ( sufentanil group),group R (remifentanil group) and group SR (sufentanil + remifentanil group),each group were twenty patients.The anesthesia of all groups is propofol intravenous anesthesia with 2％ lidocaine topical anesthesia,to controll BIS between 50 and 60 during surgery.Heart rate(HR),mean arterial pressure(MAP) pulse oxygen saturation( SpO2 ) and respiratory rate (RR) were recorded and compared 5mins after entering room(T0),30mins after the beginning of surgery(T1 ) and after surgery(T3).Arterial blood gas and the times of cough during surgery were also recorded and compared in all groups.The use of propofol and lidocaine,the wake-up time,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were also obtained.Results ( 1 ) RR decreased distinctly in group R and PaCO2 increased distinctly in group S and group R compared with that of group SR (P ＜0.05) during surgery.(2)The times of cough and the wake-up time lessened distinctly in group R and group SR compared with that of group S ( P ＜0.05 ).(3) The use of propofol and lidocaine,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were similar in all groups ( P ＞ 0.05 ).Conclusion Sufentanil compounded remifentanil by TCI combined with propofol is a safe and feasible anesthesia option for EBUS-TBNA,which provides better efficacy,high satisfaction and less side effects compared with using alone of sufentanil and remifentanil respectively.

Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82％. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis of femoral neck fractures is high and the patients with high energy trauma hould be highly paid attention to.Lengthened PFNA conforms to characteristics of biomechanical fixation and presents short operation time and solid fixation. Lengthened PFNA achieves affirmatory effects for treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures.

Objective: This study aims to investigate the correlation between the expression of FoxP3, TGF-β1, and epitheli-al-mesenchymal transition (EMT) in breast cancer and to determine the clinical significance of FoxP3. Methods: The expression of FoxP3, TGF-β1, E-Cadherin, N-Cadherin, Vimentin, and Fibronectin protein were detected in the cancer cells of 74 cases with breast carcinoma via immunohistochemistry. The correlation of FoxP3 protein with clinico-pathologic features of breast carcinoma and the re-lationships among the expressions of FoxP3, TGF-β1, and epithelial-mesenchymal transition (EMT) were analyzed. Results:The ex-pression rates of FoxP3, TGF-β1, and EMT are 36.5%(27/74), 39.2%(29/74), and 40.5%(30/74), respectively. The FoxP3 protein ex-pression in breast cancer is correlated with lymph node metastasis (P<0.05) but not with other clinico-pathological features (P>0.05). The expression of FoxP3 is also correlated with the expression of TGF-β1. Furthermore, TGF-β1 can induce EMT (P<0.05). Conclu-sion:The expression of FoxP3 is correlated with lymph node metastasis and EMT in breast cancer. Therefore, FoxP3 may be a marker for predicting metastasis.

Objective To analyze the epidemiology and clinical characteristics of epidemic encephalitis B in Yuneheng area of Shanxi Province in 2006.Methods Seventy-nine cases diagnosed with epidemic encephalitis B were enrolled in this study and correlated data,epidemic and clinical characteristics,laboratory examinations and treatment outcome were analyzed.Results Sixty-two of 79 patients(78.5%)were middle-aged or old people,all cases(100%)occurred in July,August and September,69 cases(87.3%)were peasants.All patients(100%)had fever,73(92.4%)had conscious disturbance,27(34.2%)had respiratory failure.Encephalitis B specific IgM antibody was examined and 40 cases(85.1%)were positive.Twenty cases(25.3%)had complications.When they were discharged,37 cases(46.8%)recovered completely,14 cases(17.7%)died,12 were improved and 16 were voluntarily discharged,7 cases(8.9%)left more or less neurological deficits. Conclusion The epidemiology and clinical characteristics are important basis to diagnose epidemic encephalitis B.

Objective To study the changes of blood arginine vaso-pression(AVP)levels in patients with severe brain injury after treated with mild hypotherima.Methods Seventy-eight patients with severe brain injury were divided into mild hypothermia(33～35℃)group and normothermia group.The blood AVP levels and CSF AVP levels were determined at the third and the seventh day after brain injury.Results The AVP levels in blood and CSF of mild hypothermia group were lower than those of the normothermia group at the third and seventh day after brain injury(P＜0.05).According to GOS,prognosis of the mild hypothermia group was better than that of the nonnotbcrmia group(P＜0.05).Conclusion The mild hypothermia treatment may have inhibitive effects on the production of blood AVP,CSF AVP,and brain edema.Mild hypothermia is an effective method in the treatment of acute severe brain iniury in reducing the mortality and in increasing the survival rate.

Objective To improve clinicians'understanding of nephrotic syndrome and myasthenia gravis as adverse events of penicillamine(D-PA).Methods Two patients were reported to develope adverse reaction after taking D-PA.The related literature were reviewed.Result The first case was a systemic sclero- sis(SSc)patient treated with D-PA who developed nephrotic syndrome and blepharoptosis.The second case was a rheumatoid arthritis patient treated with D-PA who developed dysphagia and drinking bucking.The clinical symptoms were improved after disconting D-PA.Their conditions were stable up to now.Conclusion D-PA is used widely for various of autoimmune diseases.Clinicians should pay attention to these special and rare adverse effects.

Objective To observe the intervention effect of acupuncture on mammalian target of rapamycin(mTOR)of hypoxic-ischemic encephalopathy(HIE)model in newborn rats.Methods Seven-day-old SD rats were randomly devided into six groups.Sham-surgery group:the bilateral common carotid arteries were separated,without ligation,and the rats were without hypoxia.HIE model group:the bilateral common carotid arteries were separated and ligated,and the rats were in low oxygen.In the sham-acpuncture group,four positions were acupunctured:from Baihui,Dazhui,Quchi and Yongquan by 1 cm after hypoxia ischemia.In acpuncture group,four positions were acupunctured:Baihui,Dazhui,Quchi and Yongquan after hypoxia ischemia,positioned according to the ordinary acupoints for acupuncture in rats.In the antagonists group,the HIE model rats were injected wortmannin 5 μl to the left ventricle.The acupuncture and antagonists group had the same operations of antagonists group and acupuncture group at the same time.All the groups were subdivided into four subgroups in terms of four time periods of 1 d,3 d,7 d and 21 d.The morphological changes of organizational structures of hypoxic ischemia side in brain tissue were observed by pathological methods.The levels of mTOR mRNA expression were detected by RT-PCR.Results In acupuncture group, acupuncture treatment for 21 d showed that acupuncture group had clearly organizational structure,regular arrangements of neurons,normal cell outline,relatively clear nucleolus,mitigated swell neuron and hyperplas-tic glial cells.Compared with that of the HIE model group,acupuncture treatment increased mTOR mRNA dramatically on day 1 ,day 3,day 7 and day 21 (Q =7.099 1 ,9.009 9,7.894 0,9.914 7,P ﹤0.05 respective-ly).The expression of mTOR mRNA in acupuncture and antagonists group was significantly higher than that in sham-surgery group on day 1 ,day 3 day 7 and day 21 (Q =9.868 9,15.843 4,21.007 2,P ﹤0.05 respec-tively).In day 21 ,compared with the sham operation group and the HIE model group,the expression of mTOR mRNA in acupuncture and antagonists group were significantly higher (Q =18.236 0,4.729 7, P ﹤0.05 respectively).Conclusion Electroacupuncture treatment can promote the expression of mTOR at the mRNA level and protect brain of newborn rats with HIE.