Objective To study the difference in fibrinogen and D-dimer between the patients with ST-ele-vation myocardial infarction (STEMI) and those with normal angiography of coronary artery.Methods 100 patients with STEMI who underwent PCI and 100 patients with normal coronary arteriograms as controls from Jan.2005 to Dec.2007 were studied.Plasma concentrations of fibrinogen and D-dimer were compared.Results There was no significant difference in gender, age, history of hypertension and diabetes and smoking between the two groups.Plas-ma concentration of fbfinogen(Fg) was higher in control group [(2.65±0.68 )g/L ] than STEMI group [(2.38±0.91)g/L] (P<0.05).The square root of plasma concentration of D-dimer was higher in STEMI group [(13.23±5.08) μg/L] than control group [(9.40±5.03)μg/L ] (P<0.01).The square root of the rate between D-dimer and fibrinogen was higher in STEMI group (9.11±4.13 ) than control group (5.92±3.35 ) (P<0.01).Conclusion The levels of fibrinogen in patients with STEMI are significantly lower than that of control group, and D-dimer is higher in the former group than in the latter group, suggesting that fresh thrombosis and secondary fibrinolysis exit in STEMI patients at the acute stage.

According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.

Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.

objective:To investigate the clinical features and prognosis of pinealoblastoma in children. Methods:The clinical data of 10 patients with pinealoblastoma were retrospectively analyzed. These patients were admitted to the Department of Radiation Oncology, Beijing Shijitan Hospital, Capital Medical University from December 2011 to December 2015. Results:This study included 10 patients, with 8 males and 2 females, with a median age of 7 years. Of the 10 patients, 5 underwent gross total resection and 5 underwent sub-total resection. The 10 patients were exposed to craniospinal irradiation after surgery. The median doses of craniospinal irradiation and tumor bed were 30.6 (25.5-36) Gy and 55.8 (50.4-60) Gy, respectively. Of the 10 patients, 4 underwent chemotherapy 1 month af-ter radiotherapy. The median follow-up period was 16.5 (1.5-49) months. The 10 patients survived. No local and distant recurrences were observed. Conclusion:Pinealoblastomas are rare, malignant, and pineal regional lesions that can metastasize along the neuroax-is. Surgery combined with adjuvant radiotherapy and chemotherapy should be applied to patients with pinealoblastoma. Prognosis is also favorable.

OBJECTIVE:To evaluate evidence situation and implementation of global national drug policies on rational pediatric drug use,and to provide decision-making reference for setting up national drug policies for rational pediatric drug use which adapt to the situation of China.METHODS:By retrieving domestic and foreign related database,scanning drug management websites of WHO,the European Union as well as many countries and regions.A pre-designed data extraction form was used to collect information of the policies of rational pediatric drug use.The information was summarized and analyzed.RESULTS:A total of 45 literatures were included,involving WHO and the European Union,the United States,Canada,Britain,Ireland,Holland,Germany,Spain,France,Australia,New Zealand,China,India,Korea,Japan,South Africa and many other countries and regions.The main points of concern for the national policies of rational pediatric drug use in all countries included promoting the development of clinical trials of children's drugs,formulating and promoting essential medicine list for children,formulating and promoting standard treatment guideline of national pediatric formulary,etc.,and promoting pediatric drug monitoring after the listing.The United States,the European Union and Japan had enacted national laws and regulations on pediatric drug clinical trials;WHO,South Africa and India had developed pediatric essential medicine list;WHO,Britain and China had established pediatric formulary.CONCLUSIONS:It is suggested that the relevant departments should refer to the experiences of the United States and the European Union and other countries and regions to establish national drug policies which adapt to pediatric disease burden and drug use in China

Objective To evaluate the knee joint function at 3-7 years after anterior cruciate ligament (ACL) reconstruction with ligament advanced reinforcement system (LARS) artificial ligament and assess the morphologic changes of LARS artificial ligament in human tissues.Methods Fifty-seven patients (58 knees) undergone ACL reconstruction with LARS artificial ligament were recruited to this multi-factor retrospective study and divided into acute injury group and chronic injury group according to time between injury and operation.LARS artificial ligament harvested from the three patients (4 knees)who had an additional surgery were observed histologically.Results Knee joint function and range of movement were significantly improved after surgery (P ＜ O.O1),however subjective and objective estimation on knee joint function presented no statistical differences between the two groups (P ＞0.05).X-ray films and MRI revealed different degree of bone tunnel progressive augmentation in average 1.5 years,indistinctive correlation of knee joint stability with bone tunnel augmentation (P ＞ 0.5) as well as no statistical difference concerning incidence of tibial and femoral bone tunnel augmentation (P ＞ 0.05).Histological observation revealed well-arranged fiber tissue growth into LARS artificial ligament as well as fibrous joint among single-beam polyester fibers as well as a bundle of polyester fibers at postoperative 2 years.Conclusions (1) LARS artificial ligament gains a satisfactory knee joint stability and function in ACL reconstruction.(2) There exists bone tunnel augmentation that tends to stability at postoperative 1.5 years,but knee joint stability is not correlated to the extent of bone tunnel augmentation after surgery.(3) Postoperative data evaluation of acute injury and chronic injury is the same.(4) Human normal fibrous tissues grow into LARS artificial ligament regularly.

Objective:we aim to determine the relationship between Cell sarcoma (c-Src) expression in patients with EOC and the disease phenotype.Methods:c-Src expression was evaluated using Western blotting analysis in 21 ovarian carcinomas and 4 normal ovarian tissues.Immunohistochemistry was used to evaluate c-Src expression in 134 ovarian carcinomas and 26 normal ovarian tissues.The association between c-Src expression and clinically pathologic characteristics were also assessed in these patients.Results:Our results indicated elevated c-Src protein in EOCs compared with that in normal tissues.The overexpression of c-Src was significantly associated with aggressive features,such as advanced disease stage,poor histological grade,lymph node metastasis,and tumor recurrence (P＜0.05).In addition,the overexpression ofc-Src is significantly associated with EOCs' prognosis.Conclusion:c-Src overexpression was significantly associated with the malignant biological behavior of tumor,suggesting c-Src as a potential preventive target in these patients.

Objective: To investigate the mortality and life loss of malignant tumors among residents in Xicheng District, Beijing from 2014 to 2021, so as to provide the evidence for formulating the control strategy for malignant tumors. Methods: Data pertaining to dead cases of malignant tumors in Xicheng District from 2014 to 2021 were collected from Beijing Integrated and Analysis Platform for Health and Disease Prevention Monitoring Information Resources. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), rate of standardized years of potential life lost (SYPLLR), average years of life lost (AYLL) and annual percent change (APC) of malignant tumors were measured to analyze the trends in mortality of malignant tumors and life loss. Results: A total of 23 202 residents died from malignant tumors in Xicheng District from 2014 to 2021, and the crude and standardized mortality rates of malignant tumors were 198.09/105 and 101.46/105, respectively. The standardized mortality of malignant tumors was 117.36/105 among men and 85.97/105 among women. The standard mortality of malignant tumors appeared a tendency towards a decline among all cases (APC=-1.515%, t=-4.289, P=0.005) and women (APC=-1.629%, t=-3.046, P=0.023), and the crude mortality of malignant tumors appeared a tendency towards a rise with age (χ2trend=49.324, P<0.001). The five most deadly malignant tumors included lung cancer, colorectal cancer, liver cancer, stomach cancer and pancreatic cancer, and lung cancer, liver cancer and colorectal cancer were the three malignant tumors with the three highest life loss, with YPLL of 18 054 person-years, 9 446 person-years and 8 179 person-years, respectively. Leukemia had the highest AYLL (15.95 years per person). Conclusions The standardized mortality of malignant tumors appeared a tendency towards a decline among residents in Xicheng District from 2014 to 2021, and men and the elderly people were at high risk of malignant tumors. Lung cancer, colorectal cancer and liver cancer were leading causes of death, leukemia was the major cause of life loss.