Objective To investigate the infection status of nanobacteria on patients with upper urinary calculi and healthy sub-jects ,and analyze the role of nanobacteria in the formation of upper urinary calculi .Methods The serum ,urine and calculus of 42 patients with upper urinary calculi were investigated by polymerase chain reaction (PCR) and by bacteria cultivation with 10% γ-FBS and PMBI 1640 .The resulting PCR products were sequenced for further comparison with the reported sequence in gene bank . The serum and urine from 30 healthy adults were used as controls .Results After 4 to 6 weeks′culture ,the white or yellow precipi-tate was visible at the bottom of the tube .The positive rate of PCR was 90 .4% in calculous patients urine and 6 .7% in healthy a-dults urine ,as the positive was 92 .8% and 6 .7% in serum .which there is significant difference (P<0 .01) .The positive rate of the nanabactria in urinary calculi was 95 .2% .The coincidence rate was 98 .72% between the PCR products and the reported sequence in gene bank .Conclusion Nanobacteria are widely existed in the serum ,urine and calculus of the patients with upper urinary calcu-li ,this indicate that the nanobacteria might be have the most important influence on the formation process of urinary calculi .

Objective To explore the roles of biomarkers of the ratios of microRNA (miRNA)in osteosarcoma.Methods The blood samples from 20 patients with osteosarcoma and 30 healthy people with similar age were choosed.The miRNA expression profiles were filtered by gene chips of high flux.The results were verified by qRT-PCR.The miRNA expression ratio was analysed by receiver operating characteristic (ROC)curve aiming to find the most predictive potential combination-type markers.Results Two hundred and fifty-eight miRNAs were found to be significantly deregulated in blood samples from 30 patients with osteo-sarcoma as compared with their matching normal blood samples (F=5.564,P<0.05).Four miRNAs were choosed from blood samples of22 patients with osteosarcoma and normal blood samples.MiR-181b,miR-199b-5p and miR-451 were significantly higher than that in normal blood sample (F=6.283,P<0.05),while miR-124 showed low expression (F=7.201,P<0.05).Furthermore,the ratio of miR-199b-5p/miR-124 showed a high sensitivity (96%)and specificity (97%).Conclusion The abnormal expression of miRNA in osteosar-coma makes it have a predictive effect.The ratio of miR-199b-5p/miR-124 could be served as combination-type biomarkers in the diagnosis of osteosarcoma.

Bonetumorisonekindofmalignanttumorwhichthreatslifeamongchildrenandadoles-cent.Osteosarcoma (OS ) and Ewing sarcoma (ES ) have been paid much attention by medical community because of their complex occurrence,development,metastasis mechanism and poor prognosis.The research showed that activation of protooncogene and mutation of suppressor gene,absence of apoptosis signal and hypox-ia-inducible factor (HIF)all participated in the occurrence,development and metastasis of OS and ES.It is suggested that clarified pathomechanism of bone tumors could provide more effective therapeutic strategies and lower the mortality of patients.

Objective To explore the necessity of EGFR?targeted therapy combined with synchronized whole brain radiotherapy ( WBRT ) for non?small?cell lung cancer ( NSCLC ) with mutated EGFR and brain metastasis by comparing the effects on prognosis between WBRT combined with tyrosine kinase inhibitor ( TKI) and TKI alone. Methods A retrospective analysis was performed in 43 patients with EGFR mutation?positive NSCLC and brain metastasis. In those patients, 24 patients received WBRT plus TKI and 19 patients TKI alone. Results The overall response rate ( RR) and 6?month intracranial disease control rate ( CR) were significantly higher in the WBRT+TKI group than in the TKI group ( 79% vs. 37%, P=0. 002;79% vs. 63%, P=0. 008). The median intracranial progression?free survival (IPFS) time was significantly longer in the WBRT+TKI group than in the TKI group ( 23. 7 vs. 8. 3 months, P=0. 025) . The multivariate analysis indicated that the control of lung cancer, WBRT+TKI, and single brain metastasis were favorable factors for substantially longer IPFS time ( P=0. 033,0. 019,0. 019) . In 23 patients with exon 19 deletion, 12 patients received WBRT+TKI and 11 patients TKI alone;compared with the TKI group, the WBRT+TKI group had significantly higher RR and 6?month CR as well as significantly longer IPFS ( 100%vs. 35%, P=0. 000;100% vs. 55%, P=0. 008;23. 7 vs. 8. 4 months, P=0. 003). In 20 patients without exon 19 deletion, however, there were no significant differences in RR or 6?month CR between the WBRT+TKI group (n=12) and the TKI group (n=8)(64% vs. 50%, P=1. 000;58% vs. 75%, P=0. 642).The median IPFS was 14. 4 and 8. 4 months ( P=0. 864) . Conclusions WBRT combined with TKI is superior to TKI alone in the treatment of NSCLC with brain metastasis. Patients with exon 19 deletion have substantially better treatment outcomes.

Objective To observe the clinical outcomes of the treatment of comminuted femoral shaft fractures with combination of intramedullary interlocking nail and shape memory sawtooth-arm block hoop internal fixator. Methods 35 cases of comminuted femoral shaft fractures were treated with combined use of intramedullary interlocking nail and shape memory sawtooth-arm block hoop internal fixator. Of the 35 cases, 25 were type B and 10 type C according to AO classification. 1 case had bilateral femoral shaft fracture of type B. Results All the fractures were followed up for 12 to 24 months (averaging 18.5 months). By second attention, all the fractures healed except 1 case who had to undergo secondary surgery because his shape memory sawtooth-arm block hoop internal fixator had dropped. The intramedullary interlocking nails were taken out 18 to 24 months postoperatively. The excellent rate was 98.2%according to Klemm grading system. Conclusion In treatment of comminuted femoral shaft fractures, the combined use of intramedullary interlocking nail and shape memory sawtooth-arm block hoop internal fixator can take advantages of the 2 devices so as to secure anatomic reduction and reliable fixation.

Objective To investigate the effect of cardiac resynchronization therapy on improving heart function and reversing left ventricular remodeling in chronic heart failure patients. Methods Eleven patients with NYHA class Ⅲ to Ⅳ heart failure, ejection fraction ≤35% and QRS duration ≥130 ms were implanted synchronous biventricular pacemaker. Serial assessment was performed before and up to 1-36 months after pacing. Results There were significant improvement of LVEF、 LVFS; and decrease in MR、 LVED and QRS duration. The NYHA class of heart function was improved from Ⅲ-Ⅳ to Ⅰ-Ⅱ. Six-minute hall walk distances were also improved. Conclusion For patients with NYHA class Ⅲ to Ⅳ heart failure and ventricular conduction delay, cardiac resynchronization therapy could reverse left ventricular remodeling and improve heart function.

Objective To design a model of the content structure of websites of large scale modern hospitals which is in keeping with Chinas realities. Methods The First Hospital affiliated to the Fourth Military Medical University was selected as a representative of large scale modern Chinese hospitals and on the spot investigations were carried out. Investigations were also made via the Internet on ten famous domestic websites of hospitals affiliated to medical universities and the first ten American hospital websites as chosen by the American News Website in 2000. The opinions of 20 experts were collected and analyzed by means of expert consultation. Results The basic features of the websites of large scale modern hospitals were summed up and a content structure of websites of large scale modern hospitals, both advanced and in keeping with Chinas realities, was designed. Conclusion There is some regularity to follow in the website contents of large scale modern hospitals and the website contents of hospitals in China are turning from the stage of information to the stage of interaction.

Objective To investigate the effect and safety of photodynamic therapy (PDT) with topical aminolevulinic acid (ALA) in moderate to severe acne. Methods Seventy patients with moderate to severe acne were randomly divided into two groups, one group was treated with topical ALA-PDT for 1-3 sessions with an interval of 2 weeks, the other group received oral isotretinoin 10 mg twice a day for 6 weeks. Patients were evaluated for efficacy on week 2, 4 and 6 after the initial treatment. A 3-month follow up was performed to monitor adverse events following the end treatment. Results The total effective rate was 97.1% in ALA-PDT group after 1-3 sessions of treatment, 80.0% in the control group on week 6, and the difference was significant between the two groups (P<0.05). Acne lesions tended to recur more slightly with a longer remission period in ALA-PDT group than in the control group. A temporary and local pigmentation was observed in some patients treated with ALA-PDT, but no scar was noticed. Conclusion Topical ALA-PDT is a simple and effective treatment option for moderate to severe acne with mild side effects.

Objective To evaluate whether the predictive value of admission hyperglycemia for mortality differs between diabetics and non-diabetics with acute coronary syndrome (ACS).Methods A total of 1534 consecutive patients admitted with ACS to Central Control Unit of Beijing Friendship Hospital were analyzed.Among these patients,1332 patients who had a venous plasma glucose record at admission were retrospectively enrolled and were stratified according to admission glucose levels with or without diabetes.The primary end point was in-hospital and 2-year all-cause mortality.Results In patients without a history of diabetes,649 patients had glucose level ≤7.8 mmol/L(group A),204 patients with 7.8-11.0 mmol/L (group B) and 142 patients ＞ 11.0 mmol/L (group C).Of those with diabetes,124 patients were in group A,142 in group B and 126 in group C.By Cox regression analysis,admission hyperglycemia (group B,HR 1.48,P =0.05 ; group C,HR 2.78,P ＜ 0.001) was an independent predictor of long-term all-cause mortality in patients without diabetes.In patients with diabetes,blood glucose ＞ 11.0 mmol/L (group C,HR 2.68,P ＜ 0.001) also independently predicted long-term all-cause mortality.Conclusions Compared with the diabetic patients,elevation of blood glucose at admission is common in ACS patients without definite history of diabetes.Admission hyperglycemia should be considered as a risk factor strongly correlated with in-hospital and 2-year all-cause mortality in patients with ACS.

Objective To observe the ultrastructural change of intestinal mucosa in mice infected with Blastocystis hominis, and to study the pathogenic mechanism of B.hominis infection. Methods 20 Kunming mice were randomly divided into 4 groups: group A treated with immunosuppressant (dexamethasone), group B without immunosuppressant, group C as normal control and group D as immunosuppressant control. Groups A and B were then orally infected with 204 cysts of B. hominis. Groups C and D were treated as control by infusing same volume of Locke′s solution. Six days after inoculation, mice in each group were killed and mucosa of ileocecum was observed by transmission electron microscope (TEM) and scanning electron microscope (SEM). Results Under SEM, B. hominis located in enteric cavity and on the surface of ileocecum mucosa. Individual parasites also invaded into mucosa and its fold. Partial destruction of microvilli on the mucosa was observed. TEM observation indicated a reduction of microvilli on the surface of absorptive cells. Mitochondrial edema, rough endoplasmic reticulum dilatation and degranulation were found on absorptive cells and goblet cells. Lymphocyte infiltration and eosinophilia were found in intercellular stroma. Pathological changes in group A were more serious than that of group B. No abnormal change on the mucosal ultrastructure was found in groups C and D. Conclusions B. hominis infection causes significant ultrastructural lesion on the ileocecal mucosa in mice. Immune status of the mice can affect the degree of the lesion due to infection.