Objective To analysis the varying degrees of the M protein staining after immunofixation electrophoresis(IFE)and study its applications in clinical diagnosis.Methods 196 cases of clinical serum samples were tested by using IFE,we analyzed the positive electrophoretic bands of M protein and performed statistical analysis by using SPSS17.0.The M proteins were analyzed ret-rospectively.Results 103 patients were diagnosed with monoclonal gammopathy in 196 patients with positive M protein bands,in-cluding 96 cases of multiple myeloma(MM)and 7 cases of other monoclonal gammopathy;93 patients were non-monoclonal gam-mopathy.By analyzing the M band staining in different clinical groups,we found that M bands were mainly with dense and thick staining in monoclonal immunoglobulin group,the dense staining rate of MM was 90.6%,and the difference between MM and the other monoclonal gammopathy was not significant(P >0.05).In contrast,M bands were in light and narrow staining in non-mono-clonal immunoglobulin group,the rate of which was 25.8%,the difference between non-monoclonal immunoglobulin group and monoclonal immunoglobulin group was statistically significant(P <0.01).The proportion of allelic band in MM,other monoclonal gammopathy,non-monoclonal gammopathy were 39.6%,28.6% and 2.2% respectively,the differences were statistically significant (P <0.01).Conclusion The M band,accompanied by allelic band in IFE staining,is helpful in the diagnosis of monoclonal gam-mopathy,especially MM.The appearance of M protein provides early warning of monoclonal gammopathy.

Objective To discuss and validate which method is more effectiveness for central placenta previa through analysing the clinical outcomes of the management of hemorrhage between uterine packing and stitching hemo-stasis during cesarean section.Methods 48 pregnant women with central placenta previa was conducted in this ret-rospective study,which were all cesarean section delivery.These patients were divided into two groups.24 patients with uterine packing with gauze in the control of massive hemorrhage during cesarean section were indetified,other-wise,the other 24 patients were conducted with sewing and ligation uterine.And then,the effectiveness and outcomes were compared.Results These all patients were alive and keep the uterus.The average estimated blood loss of the stiching group was (554 ±327)mL,obviously less than the uterine packing group,which was (828 ±584)mL,and the difference was statisatically significant (t =6.689,P<0.01 ).The rate of blood transfusion during operation was 8.33% (2/24)in the group of stiching,and was 50.0%(12/24)in the uterine packing group(P<0.05).Similar-ly,the operation time of the stiching hemostasis group,which was (48.9 ±10.0)min,was evidently shorter than (68.3 ±13.3)min of the other group(t=8.126,P<0.01).The two groups had no significant difference in therate of primary healing of incision,postoperative fever and admission time(P>0.05).Conclusion The uterine stiching is an effective,rapid and simple technique in the control of hemorrhage of central placenta previa.

Objective To investigate the high risk factors of chlamydia (CT) infection in female.Methods Enzyme linked immunosorbent assay was used to detect 120 cases of gynecological clinic,including 60 cases asymptomatic patients before abortion and 60 cases patients with symptoms of mild genital itching,vaginal secretions slight increased.CT antigen in uterine cervix were detected,and the relationship between its symptoms,age,birth time,contraception,cervical condition,the number of sexual partners,mycoplasma and CT infection were analyzed.Results Among 120 cases,there were 28 cases of CT positive,positive rate was 23.3％ (28/120).CT infection rate of symptomatic and asymptomatic patients was 16.7％,30.0％ respectively,the difference was not significant(P＞0.05).The CT infection rate of patients' age younger than 30 years was 27.8％,higher than older than 30 years (10.0％),the difference was significant(x2=3.975,P＞0.05).The CT infection rate of patients had multiple sexual partners in nearly lyear was 62.5％,higher than that had one sexual partner(9.0％),the difference was significant(x2=37.42,P＞0.05).The CT infection rate of patients didn't use contraceptive tools was 29.1％,higher than that used contraceptive tools(12.2％),the difference was significant(x2=4.319,P＜0.05).Conclusion The symptoms of CT infection are no specificity,should be targeted at screening for patients have high-risk factors,such as age less than 30 years old,have multiple sexual partners nearly 1 year and don' t use contraceptive tools.

OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P<0.05). KPS score of 2 groups were increased significantly,between 2 groups before and after treatment ,with statistical signifi-cance(P<0.05);Comparison between groups(P>0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.

? amyloid protein(A?) including A?40 and A?42 are the important bioactive substances in vivo.Their toxic and beneficial attributes in the body depend on its concentration.The brain A? level is maintained by two balances under the physiological condition.The first balance is the generation involved in ?-secretase and ?-secretase and the degradation involved in neprilysin(NEP) and insulin-degrading enzyme(IDE) of A?. The second one is the balance between the receptor for advanced end glycation products(RAGE)-mediated influx and low-density lipoprotein receptor related protein 1(LRP1)-mediated efflux of A? across the blood-brain barrier(BBB).Breakdowning any one of the two balances would result in the aggregation and precipitation of A? in the brain,which is a crucial event in the pathogenesis of Alzheimer's disease(AD).This paper reviews the regulation of brain A? level under the physiological condition and the reducing strategies on the level of brain A? under the pathological condition for developing new drugs in the treatment of AD.

Aiming at the cultivation goal and requirements as well as the current status of learning and applying medical statistics for medical doctoral students, a new idea of medical statistics teaching for medical doctoral students that combined theory with practice, science research and paper writing was proposed, with respect to improving the teaching content, teaching with clinical cases, enhancing the teaching material development, paying attention to the computer practice, and providing the writing standard for research papers.

Objective To evaluate the safety and effectiveness of conscious sedation and intravenous anesthesia used to endoscopic retrograde cholangio pancreatiography (ERCP) in treatment of extrahepatic bile duct stones.Methods A total of 100 cases of extrahepatic bile duct stones patients in treatment of ERCP were encoded by the group order,50 cases of odd used intravenous anesthesia (intravenous anesthesia group),intravenous injection of propofol; 50 cases of even used conscious sedation (conscious sedation group),muscle injection of diazepam and pethidine.Intraoperative reaction (extubation behavior,own postural changes),changes in vital signs,operating time,the success rate of stone and complication were observed in two groups.Results The incidence of intraoperative extubation behavior and own postural changes in conscious sedation group were significantly higher than those in intravenous anesthesia group [24％ (12/50) vs.2％ (1/50),18％ (9/50) vs.0],and the differences were statistically significant (P ＜ 0.01).The heart rate and mean artery pressure in two groups were decreased at 5 minutes after administration than that before operation,and the difference was statistically significant (P ＜ 0.05),but there was no statistical significance at 10 min after entering the mirror and postoperative awake compared with before operation (P ＞ 0.05).Pulse oxygen saturation between two groups had no statistical significance (P ＞0.05).The success rate of stone in two groups were 98％ (49/50).Operating time in intravenous anesthesia group was obviously shorter than that in conscious sedation group [(38.2 ± 6.3) min vs.(49.1 ± 9.9) min] (P ＜ 0.01).The complications between two groups had no statistical significance (P ＞ 0.05).Conclusion Conscious sedation and intravenous anesthesia can be used to ERCP in treatment of extrahepatic bile duct stones,but intravenous anesthesia can obviously reduce patients discomfort,shorten the operation time.

Objective To observe the acute skin and mucous membrane reactions in patients treated with concurrent radiochemotherapy for nasopharyngeal carcinoma,and to analyze the influencing factors.Methods A total of 85 nasopharyngeal carcinoma cases treated with concurrent radiochemotherapy were enrolled in the study.Fifteen clinical and laboratory indexes,including BMI,radiation dose,degree of acute oral mucous and skin reactions and blood routine test were observed weekly.Univariate and multivariate regression analysis were performed to assess the factors,and screen the independent factors.Results Multiple-factor analysis showed that the risk factors cloesly related with acute radioactive oral mucosa reactions were smoking history(OR =3.467,P ＜ 0.05),single-dose of gross tumor volume (GTV) ＞2.15 Gy(OR =3.393,P ＜ 0.05),while those with acute radiation skin reactions were diabetes history(OR =87.859,P ＜ 0.05) and hemoglobin values 1 week before radiotherapy ＞ 130 g/L (OR =21.404,P ＜ 0.05).Conclusions In the patients treated with concurrent radiochemotherapy for nasopharyngeal carcinoma,smoking history and single-dose of GTVnx is the independent risk factors of acute radiation oral mucosa reactions,while diabetes history and hemoglobin values I week before radiotherapy are the independent factors of acute skin reactions.

Objective To study CT features of thymoma,so that to improve the accuracy of CT diagnosis and differential diagnosis.Methods 31 cases of thymomas proved by surgery and pathology were examined with conventional CT scans.CT findings of thymoma were analyzed.Results The lesions in 27 cases(87.1%)were located in the anterior upper and middle mediastinum.There were benign lesion in 11,including mass-cardiovascular interface(MCI) with convex type(8 cases),flatness type(1 cases) and concave type(2 cases).20 cases were malignant lesion,including MCI with cast type(18 cases) and concave type(2 cases).Irregular invasion to adjacent organs was found in 11 cases,others included pericardiac effusion(n=6),pericardial and mediastinal invasion(n=2),pleural effusion(n=4),pneumonia(n=2),lung,bone,mediastinal lymphadens metastasis(n=2) and liver,pancreas metastasis(n=1).Conclusion CT scans is of significant value in diagnosis and differential diagnosis of thymoma.

Objective:To investigate the effect of DNA vaccine expressed Helicobacter pylori(Hp) oipA on protecting against Hp infection.Methods:The ORFs of Hp oipA had been inserted into the eukaryotic expressing vector pVAX1 and SGC-7901 cells had been transfected with recombinant plasmid pVAX1-oipA. The expression of oipA had been detected by RT-PCR and ELISA. After extracted and purified, pVAX1-oipA had been injected into BALB/c mice through muscles of right leg one time each week for three weeks(100 ?g each mouse). pVAX1 blank and normal saline had been used as the control groups. Titer of antibodies had been detected by ELISA two months after the last immunization. Based on the confirmation of immunological response in the pVAX1 groups, mice had been given orogastric challenged with live Hp Sydney strain three times(0.5?108/0.5 ml each mouse). Four weeks after challenge, mice had been sacrificed. Histological change and the colonization of Hp in the gastric mucosa had been detected by urease test, the culture of Hp, and electronic microscopy.Results:SGC-7901 cells transfected with pVAX1-oipA had expressed corresponding production at the level of transcription and translation. Immunized mice had been induced anti-oipA antibodies. After challenged with bacterium, as contrast to immunized mice groups injected with pVAX1-oipA, pVAX1 blank, normal saline, the positive rate of urease test of gastric mucosa was 0(0/10), 90%(9/10), 100%(5/5)respectively,the positive rate of cultures of Hp was 20%(2/10), 90%(9/10), 100%(5/5)respectively. Histological findings: the different degree of erosion had been observed in control group, but 80%(8/10)of gastric mucosa were normal in immunized mice.Conclusion:oipA DNA could induce effective immune response in protection against Hp infection.