Objective To analyze the pre-transplant sera of renal graft recipients for soluble CD30 level and study the correlation between sCD30 level and acute rejection (AR),lung infection or renal graft loss.To investigate the feasibility of sCD30 level for pre-transplant risk evaluation in renal transplant recipients.Methods 586 renal graft recipients were enrolled into this study,who had complete 5-year follow-up data and sufficient pre-transplant sera for analysis.Pre-transplant sera were collected for detection of sCD30 level by ELISA and patients were divided into three groups according to sCD30 level:group L (sCD30＜120 U/ml),group I (sCD30 120-240U/ml) and group H (sCD30 ＞240 U/ml).Incidence of AR,lung infection,graft loss and postoperative 5-year patients and renal allograft survival rate were compared among three groups.Correlation analysis was also performed between pre-operative sCD30 level and postoperative dialysis time,AR,or lung infection.Results The average pre-transplantation sCD30 level was significantly higher than that of healthy individuals (P＜0.01 ).During the 5-year follow-up period,the incidence of AR in groups L,I and H was 17.4％ (45/259),29.2％ (77/264) and 42.9％ (27/63) respectively,and the lung infection rate was 20.8％,8.3％ and 15.9％ respectively.There was significant differences in AR incidence and lung infection rate among these three groups (P＜0.01).The pre-transplantation sCD30 level in patients with AR was (180.0± 89.1) U/ml,which was significantly higher than in those without AR (135.3 ± 72.7 U/ml,P＜0.01).The pre-transplantation sCD30 level in patients with lung infection was (123.2±75.5) U/ml,which was significantly lower than in those without lung infection (150.7 ± 79.6 U/mL,P＜0.01).The pre-transplantation sCD30 level had a positive relationship with AR (r =0.242,P＜0.01),but a negative correlation with lung infection (r=- 0.147,P＜0.01).In group H, five-year cumulative survival rate of recipients and renal grafts was 79.4％ and 69.8％ respectively,which was significantly lower than in group L (90.3％ and 87.3％),and group I (91.3％ and 87.6％) (P＜0.05,P＜0.01),but there was no significant difference between group L and group I (P＜0.01).Conclusion Pretransplant sCD30 level in renal transplant recipients is remarkably correlated with postoperative AR and lung infection,which can be considered as an independent predictor for postoperative AR,lung infection and the risk of graft function loss.

The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional clinical data repository (CDR).
Humans ; Information Dissemination ; methods ; Medical Informatics ; organization & administration ; Medical Record Linkage

BACKGROUND:Many scholars researched the biomechanics of middle clavicle fracture plate fixation, but little researched the plate position. OBJECTIVE:To observe the biomechanical characteristics ofanterior and superior plates for clavicle fracture with three-dimensional finite element models. METHODS:Three-dimensional finite element models of clavicle fracture with anterior and superior plates were established. The stress after anterior and superior plate fixation was analyzed. The maximum stress and displacement of plate fixation for clavicular fracture were observed under compression, torsion and three-point bending. RESULTS AND CONCLUSION:(1) In the compressed condition, the maximum stressand maximum fracture displacement were similar between the superior and anterior plate fixation (P> 0.05). (2) Under clockwise twist condition, the maximum stress and maximum fracture displacement were smaler in the superior plate fixation group than inthe anterior plate fixation group (P< 0.05). (3) Under counterclockwise twist condition, the maximum stress and maximum fracture displacement were similar between the anterior and superior plate fixation groups (P> 0.05). (4) Under three-point bending condition, the maximum stress was similar between the superior and anterior plate fixation groups (P> 0.05). The maximum fracture displacement was bigger in the superior plate fixation group than in the anterior plate fixation group (P< 0.05). (5) These findings suggest that superior fixation of clavicle fracture reconstruction plate has more advantages than the anterior plate fixation.

Objective To investigate the expression of serum Golgi protein 73 in hepatocellular carcinoma(HCC) and analyze the clinical significance.Methods The expression of GP73 was measured by ELISA in 75 HCC ,30 chronic hepatitis and normal con -trols.Results The serum concentrations of GP73 were (128.3 ±33.6)μg/L,(80.3 ±19.2)μg/L and (78.3 ±18.5)μg/L in the HCC, chronic hepatitis patients and normal controls .The serum level of GP73 was significantly higher in HCC than those with chronic hepatitis and healthy controls .GP73 expression was positively correlated with clinical stage , humor size and metastasis.The positive rate of GP73 in stage was 60%,higher than the AFP positive rate(33%).Conclusions The serum level of GP73 is high in HCC and was helpful for distinguishing benign and malignant liver diseases .GP73 can be used as a diagnostic marker for HCC .

Objective To investigate the value of modified NIHSS and MRI-PC-ASPECTS for the long-term prognosis in posterior circulation ischemic stroke. Methods Seventy eight patients with posterior circulation ischemic stroke were divided into two groups depended on MRS: good outcome group and bad outcome group. General information of patients was collected and vascular risk factors, NIHSS, MRI-PC-ASPECTS of the two groups were compared. Results The scores of admission NIHSS and highest NIHSS of bad outcome group were higher than that of good outcome group. The scores of MRI-PC-ASPECTS, T admission NIHSS (42-admission NIHSS) and T highest NIHSS of bad outcome group were lower than that of good outcome group (P<0.05). The areas under the ROC curves of MRI-PC-ASPECTS+T highest NIHSS, MRI-PC-ASPECTS, T highest NIHSS and T admission NIHSS were 0.907, 0.821, 0.870, 0.744, respectively (P<0.05). Conclusion NIHSS and MRI-PC-ASPECTS can predict the functional prognosis in patients with posterior circulation ischemic stroke.

Objective To investigate the value of adenosine deaminase( ADA) for the diagnosis of tubercu-lous pleural effusion.Methods A retrospective analysis was made of 324 cases of tuberculous pleural effusion patients which were effective treated and 68 cases were diagnosed of malignant pleural effusion.By drawing receiver operating characteristic curve, the best threshold of diagnosing of tuberculous pleural effusion was determined,and the distribution characteristics of ADA in tuberculous pleural effusion were analyzed.Results When the ADA was set at 19.5U/L it was good for identifying tuberculous empyema and tuberculous pleurisy.The activity of ADA in group of different gender did not have significant difference(Z=-0.572,P=0.283).The activity of ADA had significant difference between tuberculous empyema with tuberculous pleurisy patients(Z=-2.317,P=0.01),and the same as in group of different ages between less than or equal to 45 years old with the others(Z=-2.387,P=0.008).The activity of ADA had significant difference between tuberculous empyema and tuberculous pleurisy patients of younger than 45 years old(Z=-2.740,P=0.003),but not in the group of less than or equal to 45 years old (Z=-0.267, P=0.390).Conclusion The activity of ADA is good for identifying diagnosis of tuberculous pleural effusion and malignant pleural effusion, especially in tuberculous empyema and less than or equal to 45 years old patients.The standard of diagnosis and the nature of the tuberculous pleural effusion may affect the cut-off value of ADA.

isointensity on arterial phase and hyperintensity on DWI. The combination of DWI and Gd-DTPA-enhanced MR imaging may help to accurately diagnose HCCs.

Objective To investigate the value ofin vivo proton MR spectroscopy(1H-MRS)in the assessment of large focal hepatic tumors.Methods Fifty-three consecutive patients with 54 large(no less than 4 cm in dimneter)hepatic tumors and 19 normal volunteers were:included in this study.MRS of the 25 HCC confirmed by pathological examination,the choline-to-lipid mtios(Cho/Lip)were measured by dividing the peak area of choline at 3.2 ppm and lipid at 1.3 ppm.Differences in the ratios of normal liver,benign tumors and HCC were analyzed by Dunnett-t test.The sensitivity and specificity prof'des of 1H-MRS in the diagnosis of HCC were determined by plotting receiver operating characteristic(ROC)curves.Results The mean Cho/Lip ratios for normal liver(n=17),benign tumor(n=8),and HCC(n=25)were 0.07±0.04,0.11 ±0.06 and 0.55±0.17,respectively(F=6.58,P＜0.05).A significant statistical difference was found in the mean Cho/Lip ratios between HCC and benign liver tumors or normal liver(t=2.99,2.32;P＜0.05).But there wag no difference between benign hepatic tumors and norlnal liver(t=1.53,P＞0.05).The ROC curve showed proton MRS had moderate discriminating ability in diagnosing HCC.The area under the curve was 0.77. If 0.1 was chosen ns the cut-off value for diagnosing HCC with MRS,the sensitivity and specificity for HCC were 80.0%and 62.59b,respectively.Conclusion In vivo proton MRS is technically feasible for the evaluation of focal hepatic lesions,and may be useful in the diagnosis and differential diagnosis of HCC by providing metabolic ifformafion.

AIM:To investigate effect of hypoxia on the expression of proliferating cell nuclear antigen(PCNA) a nd phenotype of cardiac fibroblasts(CFs). METHODS: The purif ied cardiac fibro blasts were cultured and divided randomly into there groups :control group, mode rate hypoxia(MH) group and severe hypoxia(SH) group. After 72 h,MTT method was u s ed to investigate the proliferation of CFs, and the ultrastructure of fibroblast s were observed with transmission electron microscopy The expression of PCNA a n d ?-actin in cardiac fibroblasts were measured by the means of immunohistochemi s try and laser scanning confocal microscopy, respectively. RESULTS: MTT A 490 nm value of MH group was significantly higher than that of control group by (18 4?25 0)% ( P

Objective To investigate the diagnostic value of bronchoscopy in smear negative pulmonary tuberculosis.Methods 65 cases with cavernous and 35 non -cavernous negative smear pulmonary tuberculosis were examined by bronchoscopy.Results The positive rates of sputum examination in the empty group,the non empty group and the total sputum examination were 49.2%,17.1% and 38%,respectively.There was statistically signifi-cant difference in sputum positive rate between empty group and non empty group (χ2 =9.942,P =0.002).The posi-tive rate of sputum was 28%.The positive rate of sputum negative and sputum positive rate was 10% after operation. Microscopically visible tracheal and bronchial abnormalities,tracheal inflammatory change rates of empty group and non empty group were 52.3%,40.0%,the difference between the two groups had no statistically significant difference (χ2 =1.381,P =0.240).The tracheal stenosis rates of hole group and non empty group were 9.0% and 11.4%,the difference between the two groups had no statistically significant difference (χ2 =0.122,P =0.727).The overall trachea abnormal changes rate was 58.0%,including inflammatory change rate 48.0% and 10.0% stenosis rate. Conclusion Bronchoscopy has significant clinical value in smear negative pulmonary tuberculosis,especially with cavernous.The positive rate will be promoted after bronchoscopy,and can find abnormal changes of tube.