Objective:To expound the importance of blood oxygen saturation index, and to analyze the detection method of oxygen saturation index. Besides, to provide scientific and reasonable basis for use and selection of clinical saturated pulse oximetry(SpO2) sensor. Methods: To adopt pertinence detection method to test six kinds of SpO2 sensors (included the original import, original domestic, import commission processing, domestic commission processing, integrated mode sensor and one-time sensor), and to detect and analyze their specifications.Results: The experiment results of six kinds of SpO2 sensor were analyzed, and their main characteristics were obtained. And then, different sensor was recommended to different department or situation according to the actual situation of different hospital.Conclusion: Various clinical department and requirement can give full play to the advantages of various types of sensor, fast detect blood oxygen index for patients, reasonably allocate SpO2 sensor, reduce using cost and improve diagnosis level, at the same time, effectively carry through adjuvant therapy after they select the most suitable SpO2 sensor.

Objective To describe epidemiological characteristics of scalp psoriasis in China,and to determine its influencing factors through a hospital-based,multicenter and large-scale survey.Methods An epidemiological survey was conducted on patients with scalp psoriasis in 42 hospitals in 11 provinces and 4 municipalities.A questionnaire was designed to collect general and clinical information of patients,including clinical type,lesion distribution,psoriasis scalp severity index (PSSI),aggravating factors,influence on quality of life,treatment course,degree of satisfaction with treatment,etc.Participants were asked to fill out the questionnaire with the help of well-trained dermatologists.Data were processed with the EpiData software.The WPS system and Epi Info 5.0 statistics software were used for descriptive analysis of the data.Results Totally,3 901 patients participated this study,and 3 586 valid questionaires were obtained.The mean age at onset of scalp lesions was (27.40 ± 13.34) years,and the male to female ratio was 1.6∶1 with a mean PSSI score of 13.61 ± 12.31.The hairline of the forehead was the most frequently affected area with the constituent ratio of forehead psoriasis being 74.3％ (2 663/3 586).The duration of scalp psoriasis reached 3 to 6 months every year in 1 136 (31.7％) patients,and the area affected by scalp psoriasis was less than 25％ of the total surface area of the scalp in 1 649 (46％) patients.The most frequent clinical presentation was scaling (92.1％),followed by erythema (80.6％),itching(76.7％),bunchy hairs (39.9％) and hair loss(18.0％).Disease aggravation was most frequently associated with seasons (76.7％),emotions (47.4％),stress (47.1％) and fatigue (46.6％).The quality of life (especially social,outdoor and entertainment activities) was reported to be negatively influenced by this entity to different degrees in 2 529 (70.5％) patients.Of these patients,583 (17.8％) received combination therapy (topical and systemic),with glucocorticoid ointment (27.5％),calcipotriol scalp solution (22.7％) and glucocorticoid-containing solution (11.9％) being the most commonly used topical drugs; only 38.6％ complied with medication requirements and doctors' advice for 3 to 5 weeks,and 35.2％ believed that the primary reason for poor compliance was unsatisfactory response to drugs.It was considered that an ideal drug for the treatment of scalp psoriasis should be highly effective (50.3％),safe (17.8％) and easy to apply (11％) with a rapid onset of action(11.9％).Conclusions Scalp psoriasis has a predilection for the hairline of the forehead with scaling as the main clinical presentation.Winter and spring seasons appear to be the most common aggravating factor of scalp psoriasis.The quality of life is negatively influenced to different degrees in many patients with scalp psoriasis.Topical corticosteroids plus non-hormonal drugs should be the first choice for the treatment of scalp psoriasis.Patients consider that the ideal drugs for the treatment of scalp psoriasis should be effective,safe,and easy to apply.

Objective To investigate the effects of chronic periodontitis on heart attack and stability of coronary artery disease (CAD). Methods Number of missed teeth was recorded and periodontal index evaluated in 266 patients with CAD, including 72 cases of acute mycocardial infarction (AMI sub-group), 91 cases of unstable angina pectoris (UAP sub-group) and 103 cases of stable angina pectoris (SAP sub- group ), and 266 healthy controls. Comparison was made between the both groups and between each sub-group and controls. Results Periodontal index in CAD group was higher than that in control group ( P 0.05). Conclusions Chronic periodontitis can affect heart attack and stability of CAD, which may be an independent risk factor for CAD.

objective To evaluate the clinical application value of ileum to the S-type of suture pro- duced orthotopic neobladder.Methods Radical cystectomy and ileal neobladder with"S"shape were per- formed in 3patients with transitional cell carcinoma.Ureter implant into neobladder with embedding nipple techniques,bottom of neobladder coincide with urethra stump.Results The average operative time to form a neobladder was 5 hours,average bleeding volume was 366 ml during operation,3 cases can control urine dur- ing daytime,nycturia 1-3 times every night.Neobladder has a large capacity,low pressure,and electrolytes of blood was normal.Conclusion The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by S shape is easy and agreeable to perform.This mode of oper- ation has low complication rates,achieves adequate capacity at low pressure,and provides satisfactory conti- nence rates.It is a fine scheme to treat invasion and multiple carcinoma of bladder.

OBJECTIVETo investigate the changes of CD4 + CD25 + Foxp3 + regulatory T cells in the peripheral blood mononuclear cells (PBMC) and their association with insulin resistance in different stages of prostate cancer (PCa).

METHODSUsing flow cytometry, we counted the CD4+ CD25 + Foxp3 + regulatory T cells in the PBMCs of 62 PCa patients (5 cases of TNM stage I, 16 cases of stage II, 21 cases of stage III, and 20 cases of stage IV) and 42 normal healthy controls, and calculated their proportion in the CD4+ T-lymphocytes. We determined the levels of fast blood glucose (FBG) and fast insulin (FINS) for the insulin resistance index (HOMA-IR), obtained the serum IGF-1 level by ELISA, and analyzed the relationship of the count and proportion of CD4+ CD25+ Foxp3+ regulatory T cells with insulin resistance by comparison between the PCa patients and normal healthy controls.

RESULTSCompared with the control group, the PCa patients showed significantly increased HOMA-IR (3.68 ± 1.42 vs 6.68 ± 1.66), decreased level of serum IGF-1 ([164.56 ± 30.58] vs [96.39 ± 21.21] ng/ml), and elevated count ([1.99 ± 0.78 ] x 10(7) vs [3.55 ± 0.29] x 10(7)) and proportion ([5.33 ± 0.65] vs [13.88 ± 0.96]%) of CD4 + CD25 + Foxp3 regulatory T cells in the PBMCs. The TNM stage was correlated positively with the count and percentage of CD4 + CD25+ Foxp3 + regulatory T cells and HOMA-IR, but negatively with the level of serum IGF-1. Meanwhile, the count and percentage of CD4 + CD25 + Foxp3 + regulatory T cells were found to have a positive correlation with HOMA-IR (r = 0.722 and 0.689, P < 0.01) but a negative correlation with the level of serum IGF-1 (r = -0.747 and -0.896, P < 0.01).

CONCLUSIONThe count and proportion of CD4+ CD25 + Foxp3 + regulatory T cells in the peripheral blood and insulin resistance increase with the elevated stage of PCa. CD4 + CD25 + Foxp3 + regulatory T cells may be involved in the occurrence and progression of PCa by regulating insulin resistance.

Aged ; CD8-Positive T-Lymphocytes ; Case-Control Studies ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Hyperinsulinism ; Insulin ; blood ; Insulin Resistance ; Insulin-Like Growth Factor I ; metabolism ; Leukocytes, Mononuclear ; Lymphocyte Count ; Male ; Prostatic Neoplasms ; blood ; immunology ; pathology ; T-Lymphocytes, Regulatory

Objective To explore the roles of follicular helper T cells (Tfh) in the pathogenesis of pemphigus and bullous pemphigoid (BP).Methods Venous blood was collected from 20 patients (including 10 cases of pemphigus and 10 cases of BP) and 20 age- and sex-matched normal human controls.Enzyme linked immunosorbent assay (ELISA) was performed to measure the levels of serum interleukin (IL)-21 and anti-BP180-NC16A antibody,and flow cytometry to detect the percentage of Tfh in peripheral blood mononuclear cells (PBMCs).The relationship of anti-BP180-NC16A antibody titer to Tfh and IL-21 levels was assessed by linear correlation analysis.Results The serum IL-21 level and Tfh percentage in PBMCs were significantly higher in patients with pemphigus than in the normal controls (95.33 ± 33.69 vs.54.50 ± 18.13 pg/ml,t =3.38,P＜ 0.01;12.08％ ± 4.74％ vs.6.15％ ± 1.62％,t =3.74,P ＜ 0.01),and higher in patients with BP than in the normal controls ( 106.70 ± 44.91 vs.55.37 ± 15.89 pg/ml,t =3.41,P ＜ 0.01; 11.85％ ± 3.14％ vs.6.03％ ± 1.74％,t =5.13,P ＜ 0.01 ).The titer of anti-BP180-NC 16A antibody was positively correlated with the percentage of Tfh (r =0.67,P＜ 0.05) and serum level of IL-21 (r=0.77,P＜ 0.01) in patients with BP.Conclusions There is a significant increase in the percentage of Tfh and serum level of IL-21 in patients with pemphigus and BP,hinting a certain role of Tfh and IL-21 in the pathogenesis of pemphigus and BP.

Background Retinal neovascularization disease is a common cause of blinding.Retinal neovascularization is related to enhancing proliferation of vascular endothelial cells.So how to inhibit proliferation of vascular endothelial cells is a hot burning issue.p21 is known to be involved in the regulation of cell cycle and therefore inhibit the cell proliferation.However,the relationship of p21 and the proliferation of vascular endothelial cells in retinal neovascularization disease is for further study.Objective The aim of this experiment was to study the proliferation of rhesus retinal vascular endothelial cells(RF/6A) and expression of p21 in RF/6A cells under the hypoxia condition,and discuss their association.Methods The RF/6A cells were cultured and passaged in vitro,then they were randomly divided into normoxia culture group(5％ CO2 +95％ O2) and hypoxia for 1 hour,3,6,12 hours group(1％ 02+5％ CO2 +94％ N2).Flow cytometer(FCM) was used to check the distribution of RF/6A cell cycle in the normoxia culture group and hypoxia for 1 hour,3,6,12 hours groups.MTT assay was used to detect and compare the cell proliferation(A570)among the various groups.The expression of p21 in the cells was analyzed by Western blot.Results FCM showed that the cells proportion of G0/G1 stage was reduced initially and then increased afterward in hypoxia for 1 hour and 3,6,12 hours groups,showing a significant difference among 5 groups (F =20.083,P =0.000),and the cells proportion of S stage and G2/M stage were increased firstly and then declined in different hypoxia groups with statistical significances (F =7.861,P =0.001 ; F =10.305,P =0.003).Compared with normoxia culture group,cells proportion of G0/G1 stage was declined and that of S stage and G2/M stage were raised after hypoxia culture,showing statistically signifcant differences(P＜0.05).MTT showed that cell multiplication capacity(A570 value)strengthened firstly and then weakened in hypoxia groups with time prolongation,showing a significant difference among all the groups(F=7.768,P=0.001),and A570 value in hypoxia for 3 hours and 6 hours groups (0.315± 0.062,0.365 ± 0.064) was significantly higher than that of the normoxia group (0.205 ± 0.063),respectively(P＜0.05).Western blot showed that the expression of p21 in the cells down-regulated at the beginning and then up-regulated with the increase of hypoxia time,and there was statistical significance (F =16.738,P=0.000).The p21 relative levels in different hypoxia groups were reduced in comparison with the normoxia group,showing statistical signifcances(P＜0.05).Conclusions Short-term hypoxia could reduce the expression of the p21 in RF/6A and induce cell proliferation initially,then p21 increases and cell proliferation is inhibited with the prolongation of hypoxia time.

Objective To study the clinical and imaging characteristics of patients with infectious sacroiliac arthritis.Method Twenty-one patients diagnosed with infectious sacroiliac arthritis were analyzed retrospectively between 2000 and 2014.The chief complaint was pain in hip and lumbosacral area.Their clinical features,laboratory tests and pathological examination results as well as CT/MRI/PET-CT images were evaluated.Results There were nine males and thirteen females eighteen (85.7％) patients had unilateral sacroiliac joint involvement.Among these patients,three were diagnosed with brucellosis sacroiliac arthritis(BSI),eight patients with tuberculosis sacroiliac arthritis (TSI),and ten patients with non-brucellosis and non-tuberculosis infectious sacroiliac arthritis (ISI).For those patients with non-brucellosis and non-tuberculosis infectious sacroiliac arthritis,white blood cell count,erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)were dramatically increased.Twelve patients were diagnosed pathologically including 6 ISI,2 BSI and 4 TSI.Twelve patients and seventeen patients were scanned by CT and MRI respectively.Two patients undertook PET-CT examination.Antibiotic therapy showed significant therapeutic effects in all patients.Conclusion Infectious sacroiliac arthritis patients with hip or lumbosacral pain as the chief complaint can be easily misdiagnosed as spondyloarthritis.Comprehensive analysis of clinical features,imaging and laboratory findings is essential for accurate diagnosis.

Objective To study the clinicopathoiogic features of four cases of extranodal follicular dendritic cell sarcoma(FDCS). Methods Four cases of FDCS were examined by histological and immunohistochemistry and in situ hybridization for Epstein-Barr virus (EBV)-encoded RNA, and the related literatures were reviewed. Results Microscopically, the neoplastic cells were spindle-shaped or ovoid with pale-stained cytoplasm, indistinct cell borders, granular chromatin, distinct small nucleoli. There were varied growth patterns in the tumour, such as fascicular, circular whorls and storiform, and abundant with intermixed small lymphocytes. There scattered multinucleated giant cells and perivascular cuffing phenomenon. There were rare mitoses. The neoplastic cells were positive for one or more of the follicular dendritic markers such as CD21, CD23 and CD35. It was variably positive for CD68, Vimentin, LCA and S-100. Staining for CD20, CD3 and CD1α were negative. Ki-67 labeling ranged from 10 %-20 %. The neoplastic cells were negative for Epstein-Barrvirus (EBV)-encoded RNA. Conclusion FDCS is a rare low-grade malignant tumor with varied growth pattern. The diagnosis should be confirmed by immunohistochemical staining. It is important to recognize its morphological characteristics to avoid confusion with other similar lesions, such as gastrointestinal stromal tumour, inflammatory pseudotumor, interdigitaing dendtritic cell sarcoma, malignant histiocytoma, lymphoepithelial carcinoma, diffuse large B-cell lymphoma, and malignant melanoma.

Objective To analyze the effect of using standardized patient (SP) tutorial in the spe-cialized training of pancreatic surgery with WeChat platform. Methods 48 surgeons participating in resi-dent standardized training in Changhai Hospital (all for postgraduate education) were enrolled as teaching object. 48 surgeons were divided into two groups: SP group (n=24) receiving WeChat combined with SP tutorial which updates learning plan, learning contents, and clinical discussion by Wechat platform and performs practical teaching by SP method, control group (n=24) receiving traditional tutorial by using tradi-tional clinical teaching methods and video teaching followed by practical teaching. The theoretical exami-nation, questionnaires and expert assessment were used to evaluate the effect of the two teaching methods. Statistical analysis was performed using the SPSS 19.0. Continuous data were expressed as median±stan-dard deviation and compared using the Student's t-test. Categorical data were compared using the Pearson's chi-square test. Results The score of theoretical examination of the two groups showed no significant difference [(85.5±7.6) vs. (81.4±14.9), P=0.238]. The results of questionnaires and expert assessment in WeChat&SP group were significantly better than those in the control group (P<0.001) other than theoretical and analytical ability (P>0.05). Conclusion WeChat platform combined with standardized patient tutorial in the specialized training of pancreatic surgery is feasible and more effective than traditional tutorial to improve teaching effectiveness.