Objective To study clinical characteristics of the patients with enosinophilic gastroenteritis(EG) and analyze the cause of misdiagnosis.Methods 6 cases of EG were analyzed in clinical characteristics,laboratory tests and endoscopy.The clinical characteristics of EG and the possible cause of misdiagnosis were studied.Results ⑴EG have a various clinical manifestation.The mucosal type have the commonest symptoms,such as epigastric pain,diarrhea.The serosal type was presented with abdominal pain,bloating.and ascites,accompanied with nausea,vomiting and low fewer.The patients in the muscular type had bowel obstruction symptom.⑵Enosinophilic counts in peripheral and bone marrow had high level(43 5?20 5)%,and it was related with condition of illness.⑶ESR,CRP and FIB were in normal range,but the IgG was low level.⑷The ascites were effusion with eosinophilia.⑸Endoscopies showed erosion and edema in antrum,duodenum and cecum,accompanied with eosinophilia infiltration in mucosa.⑹The steroid hormone therapy responsion was sensitive and all symptoms were relieved and eosinophils was recovered to normal value within one week.⑺Though their symptom recurrence was probable,good prognosis was got.Conclusions The key point for diagnsos is eosinophilia counts in peripheral blood and ascites.The biopsy of the gastrointestinal tract mucosa is also very important and helpful.

Objective To investigate the relationship between the levels of serum procalcitonin (PCT) and cardiac troponin I (cTnI) in patients with sepsis.Methods According to the severity of the disease, 126 patients with sepsis in the Department of Critical Care Medicine of Hubei Provincial Hospital of Integrated Chinese and Western Medicine from June 2013 to February 2015 were divided into three groups: sepsis, severe sepsis and septic shock groups, 42 cases in each group. The changes of lactate (Lac) and central venous oxygen saturation (ScvO2) were monitored in the three groups within 72 hours after admission, the mortality and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, the levels of serum PCT and cTnI were compared among the three groups, and the correlations between serum PCT, cTnI levels and APACHE Ⅱ score were analyzed.Results Along with the increase of patients' severity in the three groups, the levels of Lac (mmol/L) were gradually increased (prior treatment: 5.82±2.42, 7.97±3.76, 10.30±2.82; 6 hours after treatment: 3.63±1.54, 5.08±1.98, 7.50±1.35; 12 hours after treatment: 2.70±1.55, 4.13±1.96, 6.23±1.16; 24 hours after treatment: 2.58±1.35, 3.95±2.44, 5.25±1.13; 48 hours after treatment: 2.15±1.82, 3.86±2.36, 4.12±1.72; 72 hours after treatment: 1.83±1.04, 3.78±1.84, 3.74±0.87), while the levels of ScvO2 were gradually reduced (prior treatment: 0.556±0.102, 0.502±0.095, 0.402±0.092; 6 hours after treatment: 0.627±0.062, 0.557±0.083, 0.504±0.075; 12 hours after treatment: 0.658±0.076, 0.601±0.083, 0.595±0.072; 24 hours after treatment: 0.676±0.059, 0.625±0.084, 0.603±0.050; 48 hours after treatment: 0.704±0.049, 0.656±0.066, 0.615±0.035; 72 hours after treatment: 0.755±0.053, 0.707±0.066, 0.629±0.048). The higher the Lac, the lower the ScvO2, and the differences among the three groups were of statistical significance (allP < 0.01). The mortalities of patients in the septic, severe septic and septic shock groups were as follows: 11.9% (5/42), 21.4% (9/42), 38.1% (16/42); serum PCT (μg/L): prior treatment: 5.21±2.92, 17.20±4.81, 40.71±5.22; 4 days after treatment: 2.51±1.52, 10.72±3.83, 46.45±4.25; the levels of cTnI (μg/L): prior treatment: 5.31±0.82, 9.50±0.31, 15.12±3.15; 4 days after treatment: 1.16±0.62, 5.35±0.53, 9.24±1.25; APACHE Ⅱ score: prior treatment: 10.41±3.72, 20.15±5.14, 35.17±4.58; 4 days after treatment: 7.25±2.22, 14.15±4.16, 28.12±3.13. Their levels were also increased along with the increase of the septic severity. The correlation analyses showed that the serum levels of PCT was significantly positively correlated with cTnI and APACHE Ⅱ score (r value was respectively 0.922, 0.921, bothP < 0.01).Conclusion Myocardial damage often easily occurs in patients with sepsis, and the more serious the illness, the more prominent the injury.

ObjectiveTo observe the effect of auricular point sticking plus acupressure on blood pressure and lipid in hypertension patients with a dampness-phlegm constitution.MethodThe eligible subjects were randomized into antreatment group of 38 cases and a control group of 40 cases. The control group was intervened by conventional medication, while thetreatment group was additionally intervened by auricular point sticking plus acupressure. Before and after intervention, the blood pressure and lipid levels [total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL)] were detected. ResultAfter intervention, the blood pressure, TC and TG levels were decreased in thetreatmentgroup (P<0.05,P<0.01), while the changes of HDL and LDL were statistically insignificant (P>0.05).ConclusionAuricular point sticking plus acupressure can somehow improve the blood pressure, TC and TG of hypertension patients with a dampness-phlegm constitution.

Overview of the challenges faced by hospitals in China against prescription data leakage and the underlying causes is made in the paper,along with operable tactics proposed based on experience of data protection accumulated at the hospital.

Objective To investigate the expression of mutant p53,Ki-67,ER and PR in uterine endometrial carcinoma and uterine serous carcinoma,and explore their significance in differential diagnosis.Methods The samples including 37 cases of uterine endometrial carcinoma and 37 cases of uterine serous carcinoma were analyzed.The expression of mutant p53,Ki-67,estrogen receptor and progesterone receptor were performed by using the immunocytochemical (IHC) EnVision system.Data were analyzed with SPSS 11.5 statistic software.Results The positive rate of mutant p53 in uterine endometrial carcinoma was statistically lower than that in uterine serous carcinoma [21.62 ％ (8/37) vs 64.86 ％ (24/37) (P ＜ 0.01)].The positive rate of Ki-67 in uterine endometrial carcinoma was statistically lower than that in uterine serous carcinoma [37.84 ％ (14/37) vs 70.27 ％ (24/37) (P ＜ 0.01)].The positive rate of estrogen receptor in uterine endometrial carcinoma was statistically higher than that in uterine serous carcinoma [78.38 ％ (29/37) vs 32.43 ％ (12/37) (P ＜ 0.01)].The positive rate of progesterone receptor in uterine endometrial carcinoma was statistically higher than that in uterine serous carcinoma [75.67 ％ (28/37) vs 29.73 ％ (11/37) (P ＜ 0.01)].Conclusions The expression of mutant p53 and Ki-67 are higher in uterine serous carcinoma.The expression of estrogen receptor and progesterone receptor are higher in uterine endometrial carcinoma.Combined detection of mutant p53,Ki-67,ER and PR has important significance in screening and preventing uterine endometrial carcinoma and uterine serous carcinoma.

Thermoablation is a local treatment effectively used to prevent metastasis of colon cancer in the liver and can retain peripheral normal liver tissues. Ablation therapy is less invasive, easier to use, and more repeatable than surgery. This form of therapy also allows the local control of unresectable diseases. Furthermore, thermoablation can be applied as an alternative therapy for small re-sectable lesions in patients who manifest insufficient hepatic function after surgery or those with severe complications. Ablation therapy can artificially increase the surgical margin, thereby increasing the resection rate in patients. Multiple lesions in the liver and surgically inaccessible or unresectable diseases can also be removed. However, several limitations, including the local recurrence of the disease and treatment-related complications in patients, are also observed. The treatment outcome of thermoablation therapy can be further im-proved because this technique is used as a part of multimodality treatment.

BACKGROUND:Calcineurin inhibitors reduce acute rejection rates and improve short-term graft survival in renal transplantation, but its nephrotoxicity associated with long-term use of calcineurin inhibitors remains an important issue. To both avoid exposure to calcineurin inhibitors and maintain effective immunosuppression, immunosuppressive agents such as sirolimus have emerged.
OBJECTIVE:To summarize the research progress of the two main protocols of sirolimus in kidney transplantation (de novo sirolimus-based therapy without calcineurin inhibitors and protocol conversion from a calcineurin inhibitor based therapy to sirolimus).
METHODS:With the key words of“kidney transplantation, sirolimus”in Chinese and in English, respectively, a computer-based search of articles was performed in CNKI (January 2000 to September 2013) and PubMed (January 1996 to September 2013) databases. Articles with the de novo sirolimus-based therapy without calcineurin inhibitors and protocol conversion from a calcineurin inhibitor based therapy to sirolimus were included.
RESULTS AND CONCLUSION:Sirolimus may obtain the advantages of no renal toxicity, anti-tumor and lower incidence of cytomegalovirus infections when compared with calcineurin inhibitors. But not al patients are suitable for sirolimus, and to screen patients strictly is the key of satisfactory clinical results. An appropriate treatment plan, drug monitoring of sirolimus, prevention and treatment of complications are essential features of the use of sirolimus.

Objective:To investigate the patterns of microbial infection on the apical external root surfaces of treated and untreated teeth associated with chronic apical periodontitis and to study bacteria in the biofilm in order to find out the species,constitution and origination of bacteria in periapical biofilm.Methods: Ten teeth with chronic apical periodontitis from patients of the Department of Stomatology of People's Hospital,Peking University: 5 untreated teeth with a radiographically visible chronic periradi-cular lesions and 5 teeth with extensive carious lesions,radiolucent lesions of varying sizes and attached periradicular tissues were selected for study.Using aseptic techniques and sterile instruments,bacterial samples of the root canals were taken,inoculated and separated according to usual practice.After extraction,ten teeth were fixed and the apical 5 mm portion of one root was sectioned.Root tips were dehydrated,sputter coated with gold,and then examined for the occurrence of bacteria on the apical root surfaces using scanning electron microscope.Five healthy teeth with vital pulp were used as controls.Results: Microbial study showed that ten specimens yielded bacterial growth.The most prevalent bacteria were P.micros and F.nueleatum.In the 5 untreated teeth,bacterial cells were usually observed close to the apical foramen in only 1 specimen.Morphologically,these bacteria consisted of cocci.In the 5 treated teeth,a dense bacterial aggregation composed mainly of cocci and rods was observed surrounding the apical foramen of all specimens.Besides rods,other bacterial morphological types were recognized,including coaggregations of cocci and filaments,characterizing a fully developed "corn-cob".No microorga-nisms were found in the healthy controls.Conclusion:Bacterial biofilm was always present in teeth with post-treatment endodontic disease.The presence of apical bacterial biofilm is clinically important,and it may cause failure of endodontic treatment as a consequence of persistent infection.

Objective: To investigate the effect of GLP1 on the blood glucose in type 2 diabetic rats,and its protective effects on the islet B cells.Methods: Thirty rats were divided into three groups: spontaneous type 2 diabetes animal model OLETF rats,GLP-1 [from the twelfth week 56 ?g/(kg?d),sc] therapy group and LETO rats as control.In the 14th and 20th weeks,standard OGTT including fast and 2 h-plasma glucose were measured respectively.In the 14th weeks,3 rats from each group were killed randomly,and the rest of the rats were killed until the 20th week.Immunostaining with the marker of PCNA,TUNEL,and insulin assessed metabolic changes in the islet. Ultrastructure of the B cell was observed with the electronic microscope.Results: In the 14th and 20th week,AUC for insulin were higher in treated animals(10.86?1.56 vs.9.07?1.28,P

Objective To explore the risk factors of earlier neurological function deterioration in acute cerebral infarction patient.Methods 157 cases with acute cerebral infarction had been studied,including the patient's history,general syndromes,clinical characteristic,CT or MRI and laboratory test.Multivarivate noncondition stepwise Logistic model analysis was made after single variable analysis.Results There were 58 patients with neurological function deterioration in 157 cases acute cerebral infarction patient.The morbidity was 36.3%.The following nine factors were associated with earlier neurological function deterioration in acute cerebral infarction i.e. the history of hypertension and diabetes,CT or MRI abnormal,higher WBC count,fever,higher blood sugar,lover mean arterial press,higher fibrin,higher serum Fe-protein;But age,sex,weight,the history of drink and smoker,blood lipemia lever were associated with the disease.Conclusion Earlier neurological function deterioration in acute cerebral infarction patient is caused by multiple factors.Singer test is not easy to calculate the result.To analyze generally patient's clinical material may calculate if earlier neurological function deterioration in acute cerebral infarction patient takes place.