Parathyroid Hormone-related Protein( PTHrP) is a polyhormone secretory protein secreted by a variety of tissues and cells that plays fundamental roles in the growth and development of various organs, promotes migration and invasion in breast cancer, prostate cancer and non-small cell lung cancer and also plays a key role in osteolysis.With the development of scientific research, many unknown functions of the parathyroid hormone-related protein will be uncovered.

Objective:To investigate the epidemiological characteristics of bacteria and their susceptibility to antimicrobials and to establish a basis for empirical treatment of the neonatal infections. 　Methods:Identification of bacteria were performed according to the National Standard of Clinical Microbiological Test. Disk diffusion were used for antimicrobial susceptibility test.　Results: A total of 2,244 strains were isolated from the samples collected in our neonatal ward from Jan. 1987 to Dec. 1998. The predominant species ranked the first three were Staphylococcus epidermidis, Staphylococcus saprophyticus and Escherichia coli in the group I (infections acquired outside of hospital). Escherichia coli, Klebsiella and pseudomonas aeruginosa ranked the first three in the group Ⅱ(nosocomial infections). The resistance rates of bacterial isolates from group Ⅱ to antimicrobial agents including penicillin and ampicillin were significantly higher than that from group I (P＜0.05). The sensitivity rate was 82.2% by using amikacin only, but raised to 89% when combined with penicillin. 　Conclusion: Gram-negative bacteria were the main pathogens of nosocomial infections of neonates in our hospital but Gram-positive bacteria were the main pathogens of infections acquired outside of hospital. The nosocomial pathogens were more prone to developing drug resistance. It is recommended that the combinative use of amikacin and penicillin be employed as primary antibiotics for treatment of neonatal infections.

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.

This paper summarizes the nursing care of patients with extracorporeal membrane oxygenation (ECMO) for postoperative support in heart transplantation. Ten patients suffered from acute graft failure after heart transplantation and applied the extracorporeal membrane oxygenation for postoperative support. All the patients were monitored on electrocardiogram, hemodynamics, body temperature, urine volume, drainage volume, activated coagulation time, liver and renal function, free hemoglobin and colloid osmotic pressure. Nine survivals were discharged with recovery and one patient died. The duration of ECMO support ranged from 40 to 824 hours. When the heart function showed recovered based on bedside UCG. the ECMO could be weaned off uneventfully after 100 hours and the long-term clinical outcomes were good. It is suggested that close monitoring of heart & lung function during ECMO support, proper adjustment of ventilator index, intensive lung & respiratory tract care, prevention of arrhythmia, bleeding, embolism, infections, bedsores and other complications may decrease the mortality of severe patients with heart transplantation.

Objective To investigate the mechanism of renal damage due to rupture of atheroselerotic plaque of renal artery in apolipoprotein E (ApoE) knock-out mice. Methods The model for atherosclerotie renal artery stenosis (ARAS) was established by using ApoE knockout mice. The model mice with renal artery stenosis <50% were divided into the plaque rupture group and the non-plaque rupture group. Wild-type C57BL/6J mice were used as the control group. All the mice were raised under the same conditions. The renal arteries and kidneys were collected for the following analysis. Nuclear factor-kappa-Bp65 (NF-kBp65), intercellular adhesion molecule 1 (ICAM-1) and P-selectin (P-sel) were determined by Western blotting. The expression of interleukin 6 (IL-6) mRNA was detected by RT-PCR. Immunohistochemistry was performed by using serial sections to detect F4/80-related macrophages. Urine n-acetyl-β-d-glucosaminidase (NAG) activity was determined by direct enzyme-substrate coloration. Results In comparison with the nonplaque rupture group and the control group, the expression of NF-kBp65 protein in the blood, renal artery and kidney increased significantly in the plaque rupture group (P<0.05). The expression of F4/80, ICAM-1, P-sel, and IL-6 mRNA were increased significantly in the plaque rupture group (P<0.05), as compared with the non-plaque rupture group and the control group. The Ser and the activity of urine NAG in the plaque rupture group were higher than those in the non-plaque rapture group. The expression of NF-KBp65 protein differed insignificantly between the control group and the non-plaque rupture group (P>O.05). The group differences in the expression of F4/80, ICAM-1, P-sel, and IL-6 mRNA were similar to those in the expression of NF-KBp65 protein. The group differences in the activity of urine NAG and the Scr were similar to those in the expression of NF-kBp65 protein. Conclusion Rupture of atherosclerotic plaque of renal artery causes renal pathology change and renal function damage, which is mediated by inflammation.

Objective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods Between January 20,2000 and December 21,2010,109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer ring NK/T cell lymphoma were admitted to our hospital; the diagnosis was confirmed by immunohistochemistry.According to the Ann Arbor staging system,116 patients were classified as stage Ⅰ E,and 14 as stage Ⅱ E.Thirty patients received radiotherapy alone;2 patients received chemotherapy alone; 98 patients received radiochemotherapy.Results The follow-up rate was 100％.Seventy-eight patients were followed up for at least 5 years.The complete remission (CR) rate was 89.2％ in all patients.The CR rates of stage Ⅰ E patients and stage Ⅱ E patients were 88.8％ and 92.9％,respectively (x2 =0.02,P =0.837).The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86％ and 96％,respectively (x2 =1.44,P =0.230).The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0％ and 57.2％,respectively.The five-year OS rates of stage Ⅰ E patients and stage Ⅱ E patients were 60.6％ and 36.3％,respectively (x2 =0.25,P =0.615) ;the five-year DFS rates of stage Ⅰ E patients and stage Ⅱ E patients were 59.7％ and 36.3％,respectively (x2 =0.21,P =0.648).The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0％ and 48.4％,respectively (x2 =0.01,P =0.933) ; the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6％ and 48.4％,respectively (x2 =0.09,P =0.764).The grade 3-4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7％ and 54.1％,respectively (x2 =41.38,P=0.002).The radiation dose to the primary lesion and Eastern Cooperative Oncology Group (ECOG) score were correlated with OS (x2 =3.1 8,P =0.005 ; x2 =2.97,P =0.008).Conclusions The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage ⅠE and ⅡE nasal and Waldeyer ring NK/T cell lymphoma,but radiochemotherapy has higher toxicity than radiotherapy alone.The radiation dose to the primary lesion and ECOG score are the influential factors for OS.

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 analyze the pathogenic distribution and antimicrobial resistance in our hospital in 2006 and provide the rational information to use antibiotics reasonably.METHODS Flora cultivation and isolation were operated with the methods described by the National Clinical Laboratory Operational Regulations.Flora was identified with the VITEK32 automatic identifier,and bacteria-susceptibility test was operated with Kirby-Bauer method.RESULTS Totally 967 strains of pathogenic bacteria were isolated;they comprised 326 strains of Gram-positive bacteria,541 strains of Gram-negative bacteria and 100 strains of fungi.The main Gram-positive microorganisms included Staphylococcus aureus and Enterococcus faecalis,et al.The main Gram-negative microorganisms included Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Stenotrophomonas maltophilia and Pseudomonas aerugiinosa,et al.Specimen samples mainly isolated from sputum(43.85%),urine(22.34%),and secretion(10.03%).G+ microorganisms were sensitive to nitrofurantoin and vancomycin.G-microorganisms except A.baumannii and S.maltophilia were sensitive to cefoxitin,piperacillin/tazobactam,imipenem,and amikacin;the average resistant rates of A.baumannii and S.maltophilia to antibiotics were 68.20% and 64.43%,respectively.CONCLUSIONS The severe degree of bacterial multi-drug resistance is increasing,it is urgent to carry out surveillance of bacterial resistance for reasonabe use of antibiotics and decreasing the morbidity rate and the fatality rate.

Objective: To develop an HPLC method for the simultaneous determination of 3 anthraquinones components in Knoxia valerianoides.Methods: The separation was performed on a Waters Xbridge C18column(250 mm×4.6 mm,5 μm), the mobile phase A was 0.05% phosphoric acid, and acetonitrile served as the mobile phase B, and the analysis was with gradient elution;the flow rate was 1.0 ml·min-1;the detection wavelength was 280 nm;the column temperature was 30℃.Results: The linearity of lucidin, 3-hydroxymorindone and knoxiadin was 0.147-29.400 μg·ml-1 (r=0.999 6), 0.126-25.200μg·ml-1 (r=0.999 9) and 0.135-27.000μg·ml-1 (r=0.999 5), and the average recovery was 98.50%(RSD=1.20%), 98.72%(RSD=0.73%) and 101.10%(RSD=1.12%)(n=6), respectively.Conclusion: The developed method for the simultaneous determination of 3 components can be used to control the quality of Yunnan Knoxia valerianoides.

Objective To evaluate the effect of antler polypeptides from Cervus elaphus yarkandensis on MC3T3-E1 cells. Methods The concentration of antler polypeptides of Cervus elaphus yarkandensis was measured by BCA protein assay kit. MC3T3-E1 cells were cultured and analyzed by BCIP/NBT chromogenic alkaline phosphatase (ALP) staining kit. After being induced to form mineralized knot, the cells were stained by using Alizarin red staining. Three different concentrations (10, 1.0, 0.1 μg/mL) of antler polypeptides were analyzed by MTT method and micronutrients enzymes standard method to determine the effect of cell proliferation and ALP synthesis. Results The concentration of antler polypeptides was 0.07 mg/mL. The results of in vitro cell activity analysis showed that the positive rate of ALP was 90%and the mineralization knot was stained red. Compared with the control group, the different concentrations of antler polypeptides all showed the function of cell proliferation and the effect was dose-dependent after 3 d and 7 d. Compared with the control group, at the 3 d, three groups of antler polypeptides promoted synthesis and secretion of ALP (P<0.01) and the results showed a dose-dependent effect. Conclusion Antler polypeptides could obviously promote the proliferation of MC3T3-E1 cells and secretion of ALP, which indicated that antler polypeptides have certain effect on osteoporosis.