Objective To discuss the application effect of health care failure mode and effect analysis in quality control of polysomnngraphy.Methods The health care failure mode and effect analysis were applied to analyze the process of polysomnngraphy,process reengineering was carried out according to potential risk factors and causes affecting the results of polysomnography in order to ensure the continuous improvement of quality of polysomnography.Results After the improvement of the key link affecting the quality of polysomnography,the number of the patients underwent polysomnography increased from 345 in 2007 to 657 in 2010,the success rate increased from 93％ to 98％ and the doctors' trust level about polysomnography increased from 90％ to 96％.Conclusions Applying the health care failure mode and effect analysis to analyze of key link affecting the quality of polysomnography prospectively and adopting the pertinent countermeasures can effeetively improve the quality of polysomnngraphy.

Objective To select and analyze the drug types for treatment of patients with diabetes in the older adults.Methods The clinical data including age,gender,disease duration,drugs (types and frequency) for 320 elderly cases with diabetes were retrospectivly analyzed Results With aging,duration of diabetes had been extended(P＜0.05),but no difference between the sex ratio.The frequency of insulin (32.2％) and metformin (29.7％)were the highest in the selective therapy for senile diabetes patients.But other types of drugs such as alpha glycosidase inhibitor (19.4 ％),sulfonylureas for promoting secrete (10.9 ％) and thiazolidinedione (7.8 ％) also occupied certain proportion.Conclusions The metformin has been widely applied for senile diabetes patients,and it is usually need to be in combination with other drugs and be paied more attention to monitoring in the whole process.

Objective To investigate the application value of CT/MR image fusing in gross tumor volume (GTV) delineation of esophageal squamous cell carcinoma.Methods Twenty-nine patients with esophageal squamous cell carcinoma to be treated with radical surgery underwent routine CT scanning,MR T2-weighted imaging (T2WI) and diffusion weighted imaging (DWI) before surgery.Diffusion-sensitive gradient b values were taken at 400,600,and 800 s/mm2.GTVs were delineated on the CT image,CT/ MR T2WI,and CT/MR DWI respectively.The MR T2W1 image was used as the intermediary for the fusion of the CT image and MR DWI image.The length of GTVs measured under different imaging conditions were compared with the length of the resected specimen of esophagus.Results The GTV length was (44.94 ± 18.46) and (45.05 ±21.47) mm on the CT images and CT/MR T2WI images respectively.When the b values were 400,600,and 800 s/mm2,the esophageal carcinoma GTV length on CT/MR DWI images was (42.12 ± 17.79),(41.18 ± 17.17) and (39.77 ± 17.66) mm,respectively.The coefficient between the esophageal carcinoma GTV lengths on CT/MR DWI images and the pathological lesion lengths was 0.928,0.926 and 0.927 respectively.Conclusions CT/MR DWI images displays esophageal carcinoma GTV length more accurately,thus guiding the delineation of GTV effectively.

Objective To explore the effect of hepatitis B virus(HBV) on the expression of complement 3 (C3) and complement 4 (C4) and its regulatory mechanism.Methods Differentially expressed genes between HepG2 and HepG2.2.15 cells was screened by gene chip,serum complement component 3 (C3) and 4 (C4) levels in patients with HBV infection and in healthy individuals were measured by Immunoturbidimetry,HBV infectious clone pHBV1.3 was transfected into HepG2 cells,and expression of C3 and C4 was measured by RT-PCR and Western blot.Results Expression of C3 and C4 mRNA was lower in HepG2.2.15 cells than in HepG2 cells,serum C3 and C4 levels was much lower in patients with chronic hepatitis B and hepatic carcinoma as compared to healthy individuals (P＜0.05 ).HBV could downregulate the expression of C3 and C4 at mRNA and protein levels.Conclusion HBV may inhibit the expression both in vivo and in vitro.

Objective: To investigate the efficacy of treating craniocerebral trauma-related coma with acupuncture plus hyperbaric oxygen. Methods: Coma patients were randomly allocated into observation and control groups. Routine surgery or non-surgical treatment was given according to the condition of injury. The observation group received acupuncture plus hyperbaric oxygen as well as the treatment for the control group. The score was counted by the Glasgow coma scale before and after the treatment. A chi-square test was used. Results:There was a very significant difference in curative effect between the observation and control groups (P＜0.01). Conclusion: Treatment with acupuncture plus hyperbaric oxygen can promote the patients' early revival.

Animals ; Carcinogenesis ; Cell Cycle Proteins ; genetics ; metabolism ; Cyclin E ; metabolism ; F-Box Proteins ; genetics ; metabolism ; F-Box-WD Repeat-Containing Protein 7 ; Gene Silencing ; Genes, Tumor Suppressor ; Humans ; Mutation ; Myeloid Cell Leukemia Sequence 1 Protein ; metabolism ; Neoplasms ; genetics ; metabolism ; pathology ; Proto-Oncogene Proteins c-myc ; metabolism ; Receptors, Notch ; metabolism ; Signal Transduction ; TOR Serine-Threonine Kinases ; metabolism ; Ubiquitin-Protein Ligases ; genetics ; metabolism

BACKGROUND: Schizophrenia is substantially heritable, but specific susceptibility genes remain difficult to be identified. Therefore, it is necessary to explore hereditary markers first.OBJECTIVE: To investigate the relationship between schizophrenia and related vWA allele genes based on the analysis of microsatellite DNA vWA polymorphism.DESIGN: A case-controlled study with schizophrenic patients and randomly selected population as subjects.SETTING: Ward of Dalian Seventh People's Hospital and Molecular Biological Laboratory of Dalian Medical University.between March and July 2002 at Dalian Seventh People's Hospital which specializes in schizophrenia. Schizophrenia was diagnosed according to the diagnostic standard of the third edition of "the American Diagnostic Statistical Manual for Schizophrenic Diseases", and their clinical manifestations were predominantly negative signs. Altogether 123 normal blood samples were collected from random population at the Blood Center of Dalian Red Cross. They all denied psychological ailments and severe systematic diseases, and they had no kinship with each other.METHODS: Heparin anti-coagulation blood samples were collected and PCR compound amplification was carried out with the aid of PE Profiler plus system. Then the products were subjected to electrophoresis and gene detection with ABI310 type gene analysis system so as to calculate the frequency of allele genes; Hardy-Weinberg equation law was used to make coincidence test and linkage analysis of the theoretical frequency and actual one. Schizophrenic patients and random population were compared and relative risk was calculated with RR=Pd × (1-Pc)/Pc × (1-Pd) in order to assess the statistical significance (RR: relative risk; Pd: gene frequency of schizophrenia; Pc: gene frequency of random population). RR ＞ 1 was considered of higher susceptibility while RR ＜ 1 was considered of anti-susceptibility. In this way, we could find out vWA allele genes that had susceptible linkage or anti-linkage with schizophrenic related genes.MAIN OUTCOME MEASURES: Major outcome: Correlation analysis of vWA allele genes in schizophrenic patients and random population. Secondary outcome: The coincidence of vWA allele gene frequency in patients with schizophrenia and random population with what was calculated by Hardy-Weinberg law.RESULTS: Data of the two groups were processed according to the objective and statistically analyzed.① vWA allele gene frequency in patients with schizophrenia and in random population was found to coincide with HardyWeinberg law(P ＞ 0.05).② The positive rate of vWA-14 in schizophrenic patients (17.2%) was obviously different from that in random population (33.3%) (RR=0.415, P=0.014). The positive rate of vWA-17 in schizophrenic patients (31.3%) was found to be significantly higher than that in random population (19.5%) (RR=1.866, P=0.043) while it did not differ significantly in other allele genes (P ＞ 0.05).CONCLUSION: The positive rate of vWA-14 was significantly lower in schizophrenic patients than in random population, indicating that vWA-14locus may be negatively selected in schizophrenia due to some reasons,which may be approximate to anti-schizophrenia genes. Moreover, the higher expression of vWA-17 in schizophrenic patients than in random population suggests that vWA-17 locus is correlated with schizophrenia,which may be approximate to schizophrenia-susceptibile genes.

Objective:To analyze clinical and histopathological characteristics of infantile congenital melanocytic nevi (ICMN) .Methods:Clinical and pathological data were collected from 126 infants with confirmedly diagnosed congenital melanocytic nevi in Department of Dermatology, Xijing Hospital from January 2015 to January 2020, and were retrospectively analyzed. Chi-square test was used for comparisons of enumeration data.Results:Among the 126 patients with ICMN, 68 were males and 58 were females; 109 (86.5%) presented with skin lesions at birth; 73 (57.9%) were 2 - 3 years old at the first clinic visit. The skin lesions occurred on the head and face (76 cases, 60.3%) , trunk (24 cases, 19.1%) or extremities (26 cases, 20.6%) . There were 36 (28.6%) patients with small congenital nevi, 68 (54.0%) with M1-type medium-sized nevi, 13 (10.3%) with M2-type medium-sized nevi and 9 (7.1%) with giant nevi. Of 126 cases of ICMN, 121 (96.0%) had solitary lesions, 5 (4.0%) had multiple lesions, 44 (34.9%) had nevi with coarse hairs, 15 (11.9%) had nevi complicated by papules or hyperplastic nodules, and 6 (4.8%) had satellite lesions. Pathological subtypes included compound nevus (120 cases, 95.2%) , intradermal nevus (4 cases, 3.2%) , and junctional nevus (2 cases, 1.6%) . Under the microscope, the depth of the skin lesions was < 1 mm in 38 (30.1%) cases, 1 - 2 mm in 61 (48.4%) and > 2 mm in 25 (19.8%) , and 45 (35.7%) cases showed nevus cells infiltrating the subcutaneous fat layer or deeper tissues. Among the 126 ICMN lesions, common pathological features included nevus tissue maturation (100%, 2 cases of junctional nevi were excluded) , pigment granules in the stratum corneum (53 cases, 42.1%) , disordered/asymmetric distribution of nevus cells (80 cases, 63.5%) , scattered epidermal nevus cells (91 cases, 72.2%) , pagetoid spread of epidermal nevus cells (67 cases, 53.2%) , melanophages in the dermis (71 cases, 56.4%) , and nevus cells distributed along hair follicles/sebaceous glands (82 cases, 65.1%) . Special pathological features included nevus cells embedded in the vascular/lymphatic vessels (42 cases, 33.3%) , nevus cell lysis (45 cases, 35.7%) , fibromatous changes (25 cases, 19.8%) , involvement of the arrector pilli muscles (31 cases, 24.6%) , and mast cell infiltration (30 cases, 23.8%) . Pathological patterns of ICMN with different clinical features: the incidences of infiltration depth > 2 mm, pigment granules and columnar pigment granules in the stratum corneum were significantly higher in the giant nevi than in the small and medium-sized nevi ( χ2 = 7.93, 10.76, 5.89 respectively, all P < 0.05) ; the incidences of infiltration depth > 2 mm, epidermal spongiosis with scattered nevus cells, nevus cell nests distributed along the hair follicles/sebaceous glands, fibromatous changes and mast cell infiltration were significantly higher in the skin lesions with coarse hairs than in those without ( χ2 = 28.29, 8.11, 6.22, 7.92, 8.19 respectively, all P < 0.01) ; the incidences of pagetoid spread of epidermal nevus cells and atypical nevus cells were significantly higher in the skin lesions with papules/hyperplastic nodules than in those without papules/hyperplastic nodules ( χ2 = 4.92, 6.30 respectively, both P < 0.05) . Conclusions:The clinical and histopathological characteristics of ICMN are unique, and atypical nevus cells are common in ICMN. The diagnosis and treatment of ICMN need to be based on the combination of clinical and pathological characteristics.

Objective To evaluate the feasibility and safety of portal-superior mesenteric vein resection and end-to-end anastomosis in cases of colonic carcinoma invading portal vein undergoing combined right hemicolectomy (RH) and pancreaticoduodenectomy (PD) without the need of graft interposition.Methods From 2004 to 2011,5 patients underwent resection of right-sided colon and pancreaticoduodenectomy combined mesentericoportal vein resection at a length from 3 to 4 cm and end-toend anastmoses without graft.Results Surgery was successful in all 5 patients,with complete resection,no severe complications occurred,and all 5 patients were cured.Conclusions Cancers in hepatic flexure of the colon frequently infiltrates the head of the pancreas and duodenum,involving the portal vein.Conservative radical right hemicolectomy and pancreaticoduodenectomy combined long mesentericoportal vein resection and end-to-end anastmoses without graft is a reasonable and safe procedure.