Objective To investigate the change in blood lymphocyte levels and lymphocyte percentage in critical patients,including those with non-infectious systemic inflammatory response syndrome (SIRS),sepsis and severe sepsis.Methods Clinical data of 423 patients admitted to intensive care unit (ICU) of Department of Emergency of Peking University Third Hospital from January 2011 to September 2013 were retrospectively analyzed.Among these patients,there were 54 with non-infectious SIRS,177 with sepsis and 192 with severe sepsis.150 of them died,and 273 survived.The white blood count (WBC),neutrophil (N),lymphocyte count,lymphocyte percentage,lactic acid,serum high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined at admission,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was estimated.The patients were divided into different groups according to diagnosis and prognosis to compare the value of the indexes,and the correlation between lymphocyte count and other markers were analyzed by Spearman relative analysis.Results The older the patients,the more severe the disease.In the non-infective SIRS,sepsis and severe sepsis groups,APACHE Ⅱ scores (7.78 ± 3.72,13.85 ± 7.22,24.00 ± 9.79),time of stay in hospital [days:6.0 (1.0,9.0),12.0 (8.0,22.0),19.5 (7.0,29.0)],the mortality rate (0,10.2％,52.6％),WBC (× 109/L:7.59 ± 3.27,8.94 ± 3.95,10.32 ± 5.50),N (0.685 ± 0.132,0.778 ± 0.135,0.831 ±0.086),hs-CRP [mg/L:4.60 (2.80,7.52),23.58 (13.49,49.22),59.77 (19.36,110.62)] andPCT [μg/L:0.05 (0.05,0.05),0.09 (0.05,0.61),0.63 (0.10,5.25)] showed gradually increasing tendency (all P=0.000).Serum lymphocyte count levels [× 109/L:1.53 (0.89,1.88),0.90 (0.65,1.42) and 0.80 (0.50,1.12)],lymphocyte percentage (0.225 ± 0.122,0.138 ± 0.097,0.106 ± 0.070) showed gradually decreasing tendency (P＜0.05 or P＜0.01).There was significant difference in blood lactic acid among three groups [blood lactic acid were 2.40 (1.30,5.10),1.10 (0.80,2.00) and 1.40 (1.00,2.50) mmol/L in the non-infective SIRS,sepsis and severe sepsis groups respectively,P=0.000].Age (years old:76.71 ± 12.21 vs.73.21 ± 14.49),APACHE Ⅱ score (24.69 ± 9.58 vs.13.91 ± 8.41),time of stay in hospital [days:12.0 (4.0,28.0) vs.11.0 (8.0,22.0)],WBC (× 109/L:10.29 ± 5.82 vs.8.89 ± 3.98),N (0.809 ± 0.130 vs.0.776 ± 0.120),lactic acid [mmol/L:1.80 (1.10,2.90) vs.1.30 (0.90,2.49)],hs-CRP [mg/L:50.94 (19.21,97.13) vs.21.71 (6.39,54.40)] and PCT [μg/L:0.74 (0.13,5.83) vs.0.08 (0.05,0.59)] levels in the death group were higher than those in the survival group (P＜0.05 or P＜0.01),serum lymphocyte count levels [× 109/L:0.90 (0.50,1.29) vs.1.05 (0.70,1.54)],lymphocyte percentage (0.123 ± 0.098 vs.0.143 ± 0.097) level in the death group were obviously lower than those in the survival group (P＜0.01 and P＜0.05).Serum lymphocyte count levels were negative correlated with N (r=-0.597,P=0.000),hs-CRP (r=-0.298,P=0.000),PCT (r=-0.304,P=0.000),APACHE Ⅱ (r=-0.124,P=0.000),and positively correlated with lymphocyte percentage (r=0.691,P=0.000),and non correlations was found with WBC (r=0.082,P=0.091) and lactic acid (r=0.073,P=0.132).Conclusion The serum lymphocyte levels in the critically ill patients are related with the severity of sepsis,and monitoring the change in lymphocyte may be an indicator for evaluating the illness and effect of treatment.

Osteoarthritis is a common chronic degenerative disease, which is currently the main drug therapy.Hyaluronic acid (HA) is a kind of glycosaminoglycan in the interstitial cells, which has the character of viscoelasticity, lubricity, biocompatibility,biodegradability and anti-inflammatory. It is wide applicated in the treatment of osteoarthritis.However, the half-life of the common hyaluronic acid injected into the joint cavity is shorter, patients need frequent dosing and the compliance is poor, research on new uses of hyaluronic acid formulations and clinical pharmacy workers is the new direction of research.In this paper, the recent advance of HA on function, safety, effectivity and novel application in osteoarthritis therapy are summarized.

Objective To evaluate MR imaging diagnosis in acute suppurative osteomyelitis at early stage. Methods The axis, sagittal and coronal planes were performed with Philips 0.5 T superconduct MR scanner on 12 cases of acute suppurative osteomyelitis in lower extremity proved by clinical data 2 to 14 days after onset. Results Abnormal signals in marrow were displayed in all 11 cases 3 to 14 days after onset. No abnormality was found in 1 case 2 days after onset. The interface between normal and abnormal marrow became clear as time going on. The lesion presented as patchy low intensity on T 1WI and high signal on T 2WI. The signal changes were marked especially on STIR. Conclusion MRI was superior to other imaging methods in diagnosis of acute suppurative osteomyelitis.

The clinical data and findings in MRI enhanced scanning of 16 patients with meningeal carcinomatosis were analyzed retrospectively.Meningeal carcinomatosis with subacute- or chronic-onset deteriorated progressively presenting the characteristics of intracranial hypertension and meningeal irritation.Fourteen out of 16 patients showed abnormal linear and strip signal enhancement of meninges by enhancement scanning.Meningeal carcinomatosis presented in diversified patterns and contrast-enhanced MRI is of referential value for the diagnosis of the disease.

Objective To find out whether the benefits entitled to peasants have increased since NRCM is in place in Beijing, and to analyze the extent of such benefit increase if any. Methods The first is to calculate changes to the reimbursement ratio of hospitalization charges for the peasants covered by NRCM; the second is to calculate the role played by NRCM for alleviating the catastrophic health expenditure of peasants. Results The reimbursement ratio of hospitalization charges for peasants covered by NRCM rose from 32.4% in 2004 to 45.4% in 2007. Survey data from districts and counties in the sampling test indicate that NRCM has gained an ever growing power in alleviating the catastrophic expenditure of peasants. Conclusion Recent years have witnessed a marked growth in medical charges, peasants' income, and peasants' demand for medical services. Against such a background, NRCM can still sharply downsize their catastrophic health expenditure, and its role keeps intensifying. This proves that the fund raising speed of NRCM has greatly outpaced the growth of medical charges and peasants' demand for medical services, and NRCM is playing a more effective role in alleviating the peasants from poverty caused by diseases.

Objective To evaluate the valuations of the intracranial vertebrobasilar arteries using CT angiography (CTA) in order to improve the understanding of various variants in intracranial vertebrobasilar arteries.Methods The CTA images of 435 subjects were analyzed retrospectively.The data were collected by a 16-slice CT scanner.All the CTA images were processed technically by the maximum intensity projection and volume rendering.The intracranial vertebrobasilar arteries were measured and analyzed.Results Among the 435 subjects,bilateral intracranial vertebral arteries (V4) showed symmetry in 183 (42.07％) and dissymmetry in 252 (57.93％).Hypoplasia were found in 27 subjects (6.21％) on the left V4 segments and 36 (8.28％) on the right V4 segments,and a total of 21 (4.83％) were directly continued as the ipsilateral posterior inferior cerebellar arteries on the unilateral V4 segments.There were 2 subjects (0.46％) with vertebrobasilar dolichoectasia.There were 32 subjects (7.36％) had fenestration variation,3 of them (0.69％) were on the V4 segments,10 (2.30％) at the junctions,and 19 (4.37％) in the basilar arteries.Two subjects (0.46％) had persistent trigeminal arteries.Conclusions The variations of intracranial vertebrobasilar arteries mainly include angiodysplasia,vertebrobasilar dolichoectasia,fenestration variation,and persistent trigeminal artery.As a noninvasive vascular imaging method,CTA may accurately and visually assess the anatomic variation of intracranial vertebrobasilar artery,and provide imaging guidance for the preoperative evaluation of posterior fossa surgery.

Objective To design the coding User Interface of DICOM SR based on PACS and introduce the coding func- tion.Methods 1 000Mb trunk net was adopted in PACS and 100Mb was exchanged on tabletop.To exploit SQLServ- er2000 database and take the PingYingJiaJia and WuBiJiaJia as Chinese input methods.To exploit optical disk edition of ACR and ICD-10 coding system to construct coding database.To adopt the system of DICOM SR explored ourselves. Results User Interface referred to the rule and definition of DICOSR.To make report disposal and case management and statistics query and imagine teaching and HIS connection in one windows and can manipulate each other.ACR and ICD-10 coding key were set in right of diagnosis report interface.Hitting ACR and ICD-10 coding key would spring the relating coding window.Conclusion User Interface of DICOM SR was friendly.It was powerful and utility.

Objective:To observe the effect of CD34 immunoaffinity column on the isolation of hematopoietic stem and progenitor cells of cord blood and the proliferatory and expansion characteristics of CD34 + cells in vitro.Methods:CD34 +cells were isolated from cord blood using CD34 immunoaffinity column.Cell surface antigens were analysed by FACS.The separated and un separated cells were cultured with human hematopoietic growth factors(HGFS)in liquid culture system and CFU GEMM culture system.Results:CD34 + cells were enriched with a purity of 49.62%?17.69% and a recovery of 54.38%?11.91% using the immunoaffinity column.The separated CD34 +cells and cord blood MNC expanded to 561.00 folds and 44.44 folds respectively after cultured with HGFS for 20 days.The percentages of CD34 + cells in separated group and control were 53.38% and 7.91% respectively after cultured for 12 days.The number of CFU GEMM in separated group was significantly higher than that in control(P

Objective To investigate the risk factors associated to malnutrition in elderly inpatients for supplying clinical evidences for the prevention and therapy of malnutrition. Methods A one-to-one matched case-control study was used to investigate the risk factors associated to malnutrition in elderly inpatients over 60 years old. Results Eight-five pairs were included. Single factor analysis suggested that serum total protein. hemoglobin, serum total cholesterol, non auto -selective food, anorexia, dysphasia, confinement in the bed and infectious diseases might be associated with malnutrition in elderly inpaticnts (all P＜ 0.05 ). Logistic regression analysis demonstrated that serum total protein, hemoglobin, anorexia, dysphasia and confinement in the bed were the major risk factors (P＜0.05). Hosmer-Lemeshow test showed the predicable results and practical results had better similarity (x2 =4. 957, P= 0. 762). Receiver operation characteristic curve ( ROC curve) also revealed the area under curve of serum total protein and hemoglobin were 0 760 and 0.621(P=0.000 and P=0.006 respectiuely), therefore, 56.8 g/L of serum total protein and 108 g/L of hemoglobin might be appropriate reference points for evaluating the malnutrition. Conclusions Serum total protein, hemoglobin, anorexia, dysphasia and confinement in the bed may play crucial roles for malnutrition in elderly inpatients, the status of malnutrition will be improved if the reversible risk factors are amendable.