Objective To observe the dynamic change of serum levels of perioperative procalcitonin (PCT ) ,C-reactive protein (CRP) ,interleukin 6(IL-6) and N-terminal brain natriuretic peptide(NT-proBNP) in the patients with lung cancer and to evaluate their value in postoperative monitoring .Methods Seventy-two patients with lung cancer were detected PCT ,CRP ,IL-6 and NT-proBNP levels before operation and on postoperative 1-5 d .The detection results were compared between the patients with cardiac injury and infection complications .Results Postoperative levels of serum PCT ,CRP ,IL-6 and NT-proBNP were increased in all the patients ;the peak value appearance of PCT ,CRP ,IL-6 and NT-proBNP in the patients with complications were earlier than that in the patients without complications ,moreover the peak value was significantly higher than that in the patients without complications (P<0 .05);the decrease speed of PCT ,CRP ,IL-6 and NT-proBNP in the patients with complications was slower than that in the patients without complications .Conclusion The combined detection of PCT ,CRP ,IL-6 and NT-proBNP may be become an effec-tive means to differentiate the postoperative complications .

The clinical data of 8 patients with the fourth-degree laceration of perineum, who were admitted in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2004 to December 2010, were reviewed retrospectively. The causes and clinical strategies were analyzed. The fourth-degree laceration of perineum was mainly caused by improper skills of midwifery, too faster labor,insufficient estimation of fetal-weight and perineal condition and obstetric forceps in this group of patients.Primary suture was performed and all cases achieved complete healing. The improvement of midwifery skill,carefully monitoring the uterine contraction, accurate evaluation of condition of perineum and the fetal-weight and good communication between patients and midwives are the key points to prevent the fourth-degree laceration of perineum.

Objective To analyze the association of DOG1 protein with gastrointestinal stromal tumors(GIST). Methods Seventy-seven patients diagnosed with GIST between January 2005 and June 2010 were enrolled. The DOG1 expression in GIST was determined using immunohistochemistry.The result was compared with that of CD117 and CD34. Results Of 77 GIST patients, the DOG1 was expressed in 74 (96.10%) patients and CD117 in 70 (90. 9%) patients, with no significant difference between DOG1 and CD117 (P＞0.05). DOG1 expression was not related to the risk stratification of the tumor, site, age and gender (P＞0. 05). Of 7 GIST patients with negative CD117,6 patients were positive for DOG1 expression. Whereas 2 of 3 DOG1 negative patients were positive for CD117 expression. Conclusions DOG1, as a novel marker for GIST,has high sensitivity as CD117. It is a good complementarity in diagnosis of GIST when combine DOG1 with CD117, especially in diagnosis of CD117 negative patients. However, the DOG1 can not be used as an index in eveluating the risk stratification of the GIST.

BACKGROUND: It is believed that repetitive transcranial magnetic stimulation (rTMS) may produce such neurophysiological effects as regulating regional cerebral blood flow, neurotransmitters, local metabolism, and neuronal remodeling after nerve tissue injuries. The prognosis ofischemic stroke is related with the cortical function reconstruction in the ipsilateral and contralateral hemisphere of the lesion. Currently studies have not defined whether rTMS can affect the cortical function, protect ischemic neurons and promote motor functional recovery after cerebral ischemia.OBJECTIVE: To investigate the effects of rTMS on rat motor cortical excitability and neural function in acute stage of cerebral ischemia-reperfusion injury.DESIGN: Completely randomized experiment.SETTING: Electroneurophysiological Laboratory of Peking Union Medical College Hospital.MATERIALS: The experiment was completed in the Zoological Research Center of Peking Union Hospital from January to June 2004. Totally 22adult male healthy Wistar rats were randomly divided into treatment group and the control group with 11 in each.METHODS: After determination of the average motor threshold of the right hind limbs, which was 22% of the maximum output, the rats were subjected to middle cerebral artery occlusion for 1 hour followed by reperfusion for 72 hours. At each time point of immediately and at 12, 36 and 60 hours after the initiation of reperfusion, the rats in the treatment group received rTMS treatment (20 Hz, 40% maximum output, 5 seconds for each session with an between-session interval of 2 minutes for a total of 10 sessions), and the site for motor threshold evaluation was used for rTMS stimulation; the rats in the control group recevied no treatment after model establishment. Motor threshold testing was performed in both groups 4 hours after the last session of treatment to avoid immediate-early effects of rTMS on the motor threshold. At 24 and 72 hours of reperfusion, the scores of neural function were recorded according to evaluation systems. All the rats with scores between 1 and 3 were enrolled in statistical analysis were evaluated between.MAIN OUTCOME MEASURES: ① Motor threshold of the rats in both groups before and after injury; ② Neural function scores at 24 and 72 hour reperfusion; ③ Infarct volume at 72 hour of reperfusion.RESULTS: Totally 13 rats entered the final result analysis. Before injury,motor threshold in the treatment and control group was similar (P=0.71),and after the injury, the motor threshold of the control group was 1.49times that of the treatment group but such difference was not statistically significant [(41.62±24.73)% vs (28.00±9.35)%, t=-1.17, P=0.27]. At 24hours of reperfusion, the functional scores of the treatment group and control group were not significantly different (P=0.46), but at 72 hours, the scores of the treatment group were significantly lower than that of the control group (1.60±1.52 vs 7.75±3.62, t=-3.57, P=0.004). The average infarct volume of two groups was (62.00±60.88) mm3 and (20.00±12.41) mm3 at 72 hours of reperfusion, respectively, which, after logarithm transformation,was not significantly different between the two group (t=-1.31, P=0.22),but when the infarct volume was transformed into Log10 values, a significant difference occurred between them (P=0.045).CONCLUSION: rTMS may stabilize and prevent the increment of the motor threshold, time-dependently relieve the neural function disability and reduce the infarct volume after cerebral ischemia-reperfusion injury.

Objective To explore the effect of antinuclear antibody ( ANA+dsDNA),extractable nuclear antigen (ENA) and antineutrophil cytoplasmic antibody (ANCA) on the clinical manifestation and cerebrospinal fluid characteristics of neuromyelitis optica (NMO).Methods All 41 patients with NMO in PUMC hospital from 1985 to 2009 were retrospectively reviewed.All patients underwent examination of serum ANA+dsDNA,ENA and ANCA.Fourteen positive-autoantibody patients were compared with 27negative-autoantibody patients in gender,onset age,duration,relapse ratio,first demyelination event,the extent of optic neuritis and myelitis,EDSS,CSF protein,WBC,Oligoclonal band, 24 hours IgG index and myelin basic protein.Results The 14 NMO patients (34.1%) had positive non-organ-specific antibodies.NMO patients who had negative autoantibodies were compared with NMO patients with positive autoantibodies with significantly higher EDSS (the EDSS score were 4.5 and 2.5 respectively,U=92.5,P=0.008),more complete damage of spinal cord (3/14 vs 0/27, x2=6.736, P=0.0095) and tended to have higher visual Function Scale in remitting phase.There was no significant difference on the gender,onset age,duration,relapse ratio,first demyelination event.The positive-autoantibody patients had higher CSF WBC (2.0 vs 0,U=68.0,P=0.007) and tended to have lower 24 hours IgG index (-8.663 vs 0.163,U=30.0,P=0.053).There was no significant difference in CSF protein,MBP and OB.Conclusion NMO patients with positive autoantibodies have more severe intrathecal autoimmune inflammatory and disability,so they might need more intensive treatment.

Objective To study the relationship between intradialytic hypertension (IDH) and inflammatory factors in patients with maintenance hemodialysis.Methods Forty maintenance hemodialysis patients were involved,including 20 patients with IDH (IDH group) and 20 patients without IDH(non-IDH group) during hemodialysis.All of them had no sign of acute infections or other progressive disease.The levels of C-reactive protein (CRP),interleukin (IL)-1 β,IL-6,tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay (ELISA) before hemodialysis and 1,2,4 h after hemodialysis.The correlation of hypertension to CRP,IL-1 β,IL-6,TNF-α was analyzed.Results The levels of CRP,IL-1β,IL-6,TNF-α were increased in IDH group with the progress of hemodialysis,but were stable innon-IDH group.Logistic regression analysis indicated that there were positive correlations between CRP (r =0.3652),IL-1β (r =0.3261 ),IL-6(r =03156),TNF- α (r =0.3324) and blood pressure during hemodialysis (P ＜ 0.01 ).Conclusion The levels of CRP,IL-1β,TNF-α,IL-6 are positively related to the IDH in maintenance hemodialysis patients.

Objective To summarize the data of cosmetics dermatosis happened in Bering in 2006 and to analyze their characteristics of this side effect.Methors The outpatients in the Department of Dermatology.Air Force General Hospital from Jun.2006 to Dec.2006 were investigated and screened out the cosmetic dermatosis according to GB17149.1～7-1997,the patients'age,gender,job and the demographic data and the suspected cosmetics were recorded and analyzed,and the routine patch tests using the involved cosmetic products were carried out in each patient.Results 327 cases of cosmetic dermatosis were reported.Among all cases.98.47% of the patients were female,and most of them aged between 21 and 40 years old:The suspected cosmetics included 47 brands with 618 imposed products,43 brands with 293 domestic and the joint venture products,and 14 illegal products;Clinically,318 cases(97.24%)of the lesion were diagnosed as cosmetic contact dermatitis.7 acne and 2 skin discoloration.Conclusion Cosmetic contact dermatitis is the most common cosmetic dermatosis,and the young and middle-aged females with middle or high education are the most susceptible people to cosmetic dermatosis.

Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI<25 kg/m2 (normal weight group),the intra-opera-tive and postoperative indicators and surgical complications were compared between two groups.Results In obesity group,72(72.00%)patients had intra-operative blood loss of >60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration of surgery,and more bleeding are high risk factors for SSI in colorectal cancer patients.

Objective To explore the diagnostic value of serum and cerebral spinal fluid (CSF) aquaporin 4(AQP4)-IgG detected by indirect immunofluorescence assay (ⅡFA) using monkey optical nerve and AQP4 transfected cell as base in neuromyelitis optica (NMO).Methods Serum and CSF AQP4-IgG in 32 NMO patients,41 multiple sclerosis (MS) patients,33 non-inflammatory neurological disease (NIND) patients and serum AQP4-IgG in 20 healthy controls (HC) were detected by monkey optical nerve/AQP4 transfected cell-based IIFA.Results (1) In both optical nerve and AQP4 transfected cell based IIFA,compared with MS,NIND and HC,the patients with NMO had significantly higher positive rate of AQP4-IgG in both serum (optical nerve-based IIFA:NMO 46.9％ (15/32),MS 7.3％ (3/41),NIND 3.0％ (1/33),HC 0 (0/20),P ＜ 0.01 ; cell-based IIFA:NMO 84.4％ (27/32),MS 2.4％ (1/41),NIND 3.0％ (1/33),HC 0 (0/20),P ＜0.01) and CSF (optical nerve-based ⅡFA:NMO 21.9％ (7/32),MS 0 (0/41),NIND 0 (0/33),P ＜ 0.01 ; cell-based IIFA:NMO 56.3％ (18/32),MS 0 (0/41),NIND 0(0/33),P＜0.01); sensitivity of serum AQP4-IgG (optical nerve-based IIFA 46.9％; cell-based IIFA 84.4％) was significantly higher than that of CSF AQP4-IgG (optical nerve-based IIFA 21.9％,P ＜0.01 ; cell-based IIFA 56.3 ％,P ＜ 0.05),while no significant difference was found in specificity between serum and CSF AQP4-IgG in diagnosing NMO; using combination of serum and CSF AQP4-IgG applied,the sensitivity increased (optical nerve-based IlFA 46.9％ vs 50.0％ ; cell-based IIFA 84.4％ vs 87.5％) while specificity remained no change.(2) Compared with optical nerve-based IIFA (serum 46.9％,CSF 21.9％),cell-based IIFA had higher sensitivity in diagnosing NMO (serum 84.4％ ; CSF 56.3％,P ＜ 0.01),while no significant difference of specificity between these two methods.Conclusion It has better clinical value to detect serum and CSF AQP4-IgG at the same time by AQP4 transfected cell based IIFA in diagnosing NMO.

Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.