Objective To investigate the correlation between vitamin E and community acquired pneumonia (CAP) .Methods A total of 128 cases of CAP(CAP group) and 135 people undergoing the healthy physical examination (excluding CAP ,control group) in our hospital from Jan .2016 to Dec .2016 were chosen .Each group was divided into the age subgroups of 0-17 years old ,18-40 years old and 41-65 years old .Vitamin E ,Chlamydia pneumoniae(CPn) and mycoplasma pneumoniae(MP) were detected in all the subjects .Then the obtained data were statistically analyzed .Results The average vitamin E was (15 .43 ± 4 .37)mg/L in the control group and (6 .37 ± 3 .24)mg/L in the CAP group ,the difference between the two group was statistically significant(P<0 .05) .In the control group ,there were 7 cases of MP positive and 6 cases of CPn positive .In the CAP group ,there were 32 cases of MP posi‐tive and 25 cases of CPn positive .The differences of MA and CPn positive between the two groups were statistically significant(P<0 .05) .The vitamin E levels in the 0 -17 years old ,18 -40 years old and 41 -65 years old subgroups of the control group were (14 .75 ± 4 .12) ,(16 .42 ± 4 .35) ,(16 .42 ± 4 .35)mg/L respectively ,while which in the various subgroups of the CAP group were (5 .43 ± 3 .18) ,(7 .74 ± 3 .65) ,(7 .74 ± 3 .65)mg/L respectively ,the difference in different age groups between the two groups was statistically significant(P<0 .05) .Conclusion Maintaining a high level of serum vitamin E level could effectively prevent CAP .

Objective To evaluate the clinical value of prenatal ultrasound in the diagnosis of congenital anal atresia.Methods A retrospective analysis was studied from January 2013 to December 2015 which analyzed abnormal sonographic features by prenatal ultrasound screening in 13 cases of anal atresia.Results 13 cases of anal atresia were confirmed after abortion,miscarriage or birth which were not probed target ring signby prenatal ultrasound screening.That included 2 simple atresia cases and 11 cases associated with other malformations and abnormalities including 8 cases with bowel dilatation and 3 cases with intestine visible echogenic meconium. Conclusion Prenatal ultrasound screening for fetal congenital anal atresia can be detected.But for lacking of specific diagnostic standard,the detection rate of anal atresia remains very low.

OBJECTIVE:To observe the clinical efficacy of omeprazole plus colloidal bismuth pectin and amoxicillin in the treatment of duodenal ulcer(DU) and on which a cost-effectiveness analysis was performed.METHODS:80 patients with DU were randomly assigned to receive omeprazole+colloidal bismuth pectin+amoxicillin(Group A,n=40) or omeprazole+clar-ithromycin+amoxicillin(Group B,n=40).After the completion of treatment,gastroscopic examination was performed to observe the cure rate of DU and the improvement of clinical symptoms.The cost-effectiveness ratios were compared.RESULTS:In the two groups(A vs.B),the cure rates under gastroscope were 100.00% vs.87.50%(P

OBJECTIVE:To understand the demands of clinic patients for relevant knowledge of drugs in order to provide more patient-targeted pharmaceutical service.METHODS:The consultation records between Jan,2004 and Dec.2004 were collected and reviewed,and the analysis was made in the respect of items,ways,and contents of consultation.RESULTS:The understanding of professional and nonprofessional demands of the patients,age distribution of major patient group and the like could provide the reference for pharmacists in deciding important patients.CONCLUSION:Retrospective analysis is a way to dynamically follow up clinic patients and obtain information,which helps the development of hospital pharmacy,and promotes medicinal consultation.

Objective To evaluate clinical risk factors that can predict brain metastasis after complete resection of small cell lung cancer (SCLC) and to assess the role of prophylactic cranial irradiation (PCI) in such kind of patients.Methods Eighty-eight patients with completely resected stage Ⅰ - Ⅲ SCLC from Jan.2000 to Dec.2009 in our hospital were retrospectively analyzed.Kaplan-Meier was used to compare the differences in the incidence of metastasis free survival in different groups.Logistic model was used to assess the independent risk factors for brain metastasis.Results The follow-up rate is 100％,and 37 patients were followed up for more than three years.None of the 3 patients who received PCI developed brain metastasis,while for patients without receiving PCI,24％ developed brain metastases.The incidence of brain metastasis for stage Ⅰ,Ⅱ and Ⅲ SCLC after surgery were 4％,26％ and 29％ ( x2 =7.57,P =0.023),respectively.The median survival time and the 3-year survival rate were 18 months and 25％ for patients who developed brain metastasis,and 48 months and 59％ for those without brain metastasis ( x2 =10.63,P =0.001 ).Both univariate and multivariate analyses showed that pre-treatment disease stage wasindependent risk factor for brain metastasis ( x2 =7.57,8.52 ; P =0.023,0.004 ).Age,sex,tumor location,pathological type,induction chemotherapy,and postoperative chemotherapy/radiotherapy were not significantly correlated with the incidence of brain metastasis ( x2 =0.03,0.00,0.00,2.58,0.01,1.23,0.84;P =0.869,0.998,0.992,0.109,0.936,0.266,0.361,respectively).Conclusions Pre-treatment disease stage was independent risk factor for brain metastasis in SCLC.PCI may be important for stage Ⅱ -Ⅲ SCLC but not for stage Ⅰ disease.<英文关键词>=Carcinoma,small cell lung/surgery; Neoplasm metastasis,brain/prophylactic irradiation; Factors analysis

Objective To investigate the prognostic factors and the clinical outcome of locally recurrent rectal cancer after radical resection. Methods From April 2000 to April 2004, 105 patients with locally recurrent rectal cancer after radical resection were re-treated in Tianjin cancer hospital. Thirty-four patients were re-treated with surgery combined with adjuvant chemoradiotherapy (group 1), 35 with surgery alone (group 2), and 36 with chemoradiotherapy (group 3). The impact of 17 clinicopathological factors and treatment modalities on the survival was analyzed. Results The follow-up rate was 95. 2%. The median survival time was 23 months. The 1-, 3-and 5-year survival rates of patients with locally recurrent rectal cancer were 63% ,34% and 19%, respectively. The 1-, 3-and 5-year survival rates were 79%, 55% and 32% in group 1 ; 68%, 40% and 14% in group 2; and 64%, 36% and 11% in group 3; respectively (χ~2 =7. 96,P =0. 019). The univariate analysis showed that the degree of differentiation, depth of tumor invasion, number of metastatic lymph nodes, initial TNM stage, recurrent location, time to recurrence, and surgery combined with adjuvant therapy were significant prognostic factors, with the last 4 being the independent prognostic factors. Conclusions Surgery combined with chemoradiotherapy may improve the survival of patients with locally recurrent rectal cancer.

Objective To validate the value of Cleveland Clinical Score in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 230 adult patients were included.Based on Cleveland Clinical Score,the patients were divided into 3 risk stages:0 to 2 point,3 to 5 point,and 6 to 8 point.The incidence of RRT-AKI were compared between different stages.And the predictive value of the Cleveland Clinical Score model was assessed by area under the receiver operating characteristic curve(AUC-ROC) and the model calibration was assessed using the Hosmer-Lemeshow test.The patients were also divided into two groups:Non-RRT group and RRT-AKI group.The mortality were compared between these two groups.Results The incidence of RRT-AKI was 1.67％ vs the predicted ratio of RRT-AKI 1.70％ (x2 =0.018,P =0.892).Among the stage 1,2,and 3,the actual incidence of RRT-AKI,was 1.23％,2.66％,and 16.7％ vs the predicted incidence 0.40％,1.80％,and 9.50％,respectively.The AUC-ROC for Cleveland Clinical Score predicting RRT-AKI was 0.64 [95 ％ CI(0.57,0.71),P ＜0.01].Compared with Non-RRT group,the RRT-AKI group got a higher mortality(87.00％ vs 1.50％,x2 =1 330,P ＜0.01).Conclusion The Cleveland Clinical score had no real predictive value for RRT-AKI in Chinese adult patients after cardiac valve surgery.The incidence of RRT-AKI of the whole population and the stage 3 patients could be predicted by the model.And the patients with a high Cleveland score got a higher mortality than that of patients with a low Cleveland score.

Objective To validate the value of Simplified Renal Index Score(SRI) in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 183 adult patients were included.Based on SRI Score,the patients were divided into 3 risk stages:0 to 1 point,2 to 3 point,and 4 to 8 point.The incidence of RRT-AKI was compared between different stages.And the prediction value of the SRI model was assessed by area under the receiver operating characteristic curve (AU-ROC) and the model calibration was assessed with the Hosmer-Lemeshow (H-L) test.Results After surgery 52 (1.6％) patients developed acute kidney impairment and subsequently underwent renal replacement therapy.Patients with low values of simplified renal index (0-1),medium(2-3) and high values (4 and more) were found to have increasingly higher risk for renal replacement therapy of 0.8％ (95％ CI:0.005-0.012) 、3.8％ (95％ CI:0.026-0.052) 、20％ (95％ CI:0.010-0.720),respectively.TheAU-ROCwas0.68(95％ CI:0.610-0.760,P＜0.01).The H-L test was x2 =2.45,P=0.29.Conclusion SRI model gives a certain clinical significance,suggesting that high-values patients may occur RRT-AKI with a significantly higher risk than low-values patients.However,SRI model cannot give an accurate prediction value for RRT-AKI in Chinese adult patients after cardiac valve surgery.Direct clinical use of the model should be considered cautiously.

Objective To evaluate the role of large conductance calcium-activated potassium (BKCa) channels in vascular hyporesponsiveness in rats with obstructive jaundice.Methods Eighteen male Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),sham operation group (group S),and bile duct ligation group (group BDL).Obstructive jaundice was produced by common bile duct ligation.At 7 days after surgery,blood samples were collected for determination of the levels of serum total bilirubin (TBL),direct bilirubin (DBL),indirect bilirubin (IBL),alanine aminotransferase (ALT),and aspartate aminotransferase (AST).Thoracic aortic rings were prepared,and the endothelium was removed.The aortic rings were sequentially perfused with different concentrations of norepinephrine (NE) and sodium nitroprusside (SNP),and the maximum amplitude of contraction and dilatation of aortic rings was recorded.The aortic rings were then perfused with BKCa channel blocker Chtx with the final concentration of 10 7 mol/L,followed by perfusion with different concentrations of NE and SNP again,and the maximum amplitude of contraction and dilatation of aortic rings was recorded under each concentration.The percentage of maximum contraction and dilatation (maximum amplitude after Chtx administration÷maximum amplitude before Chtx administration× 100％) was calculated.Results Compared with C and S groups,the levels of TBL,DBL,IBL,ALT and AST in serum were significantly increased,the maximum amplitude of NE-induced contraction of aortic rings was decreased,and the percentage of the maximum NE-induced dilatation of aortic rings was increased,the maximum amplitude of SNP-induced contraction of aortic rings was increased,and the percentage of the maximum SNP-induced dilatation of aortic rings was decreased in group BDL.Conclusion Excessivc opening of BKCa channels may be involved in the mechanism of vascular hyporesponsiveness in rats with obstructive jaundice.

Objective To study the optimum determination conditions for lymphocytic proliferation by CCK-8 method in mice.Methods To study the different influence factors of spleen cell proliferation experiment stimulated by mitogen concanavalin A (ConA) or lipopolysaccharide (LPS),including cell preparation method,lymphocytic density,FBS and stimulating agent concentration in culture medium,and stimulating immediately or 24 h after preparing cell,with cross design or two factor completely randomized design.Results Spleen lymphocytic proliferation rate of preparation method by light suppression was higher than that of the light grind.The appropriate concentration of spleen cells was 5 × 106/mL.The proliferation rate has no significant difference after being stimulated for 48 or 72 h by ConA (2,5,or 1 0 μg/mL) or LPS (10,20,or 50 μg/mL) under 10％,15％,or 20％ FBS concentration in culture medium.The proliferation rate of stimulating immediately after preparing cell was higher than that of 24 h after preparing cell.Conclusion The optimum conditions of Balb/C mouse spleen cell proliferation assay stimulated by ConA and LPS are as follows:preparation of spleen cells with light pressure,spleen cell concentration of 5 × 106/mL,direct stimulation with 2-10 μg/mL ConA or 10-50 μg/mL LPS in the day of preparation.