dy for public hospitals.Discussions in relation were made on these subjects in an effort to offer references for the financial subsidy system for public hospitals.

Objective To explore skeletal‐related events (SREs) clinical factors and analysis prognosis factors on patients with non‐small cell lung cancer(NSCLC) with bone metastases .Methods We collected clinical data of pathology confirmed 383 patients with non‐small cell lung cancer between April 2007 and January 2007 in the third affiliated hospital of the third military medical uni‐versity .It was used to screening for Emission Computed Tomography (ECT ) for bone metastases .And then it was need to con‐firmed for CT ,MRI or PET‐CT or pathology .Statistics in patients between clinical features and the SREs prediction factor with Univariate and Multivariate .And Kaplan‐Meier method analysis of survival in the non‐small cell lung cancer patients with bone me‐tastases .Results Out of 383 patients with bone metastases ,178 patients with SREs .The incidence was 46 .5% .Univariate analysis showed that women ,adenocarcinoma ,never smoking history ,single bone metastases ,bisphosphonate therapy ,targeted therapy in patients with bone metastases are less likely to have SREs ,it was considered statistically significant (P<0 .05) .Multivariate analy‐sis showed multiple bone metastases and no bisphosphonate therapy is independent risk factors for SREs .Median survival time was 14 .5 months in non‐small cell lung cancer patients with bone metastases ,1 year survival rate was 46 .5% ,2 years survival rate was 15 .9% .The survival analysis shows that more bisphosphonate treatment and bisphosphonate with EGFR‐TKI therapy on the prog‐nosis of patients with statistically significance (P<0 .05) .Conclusion It was likely to occur SREs in NSCLC patients with bone metastases .No bisphosphonate and multiple bone metastases are independent risk factors for SREs .Bisphosphonate treatment may prevent or reduce occur SREs for NSCLC patients with bone metastases ,and it may prolong survival ,it speculated that bisphospho‐nate may have resistant NSCLC cell activity .

Objective To observe the clinical application of extraperitoneal cesarean section(ECS) plus forceps vs transperitoneal cesarean sections(TCS) in repeated cesarean section.Methods 98 multiparous women with scar uterus for elective repeated cesarean sections were recruited retrospectively,47 cases for ECS plus forceps(group A),and 51 cases for TCS(group B).The multiparous women with hyperglycemia not controlled,severe preeclampsia,heart disease,placenta previa,premature rupture of membrane,a history of ＞ 1 cesarean section,myoma and/or ovarian neoplasm were excluded.Results Skin incision to baby delivery time and total operation time of group A were (7.7 ± 2.8) min and (42.8 ± 9.7) min,respectively,which were significantly shorter than (9.3 ± 3.2) min and (47.6 ± 9.4) min of group B,(t =2.700,2.497,P =0.008,0.014).There was significant difference in blood loss volume during the operation and postoperative 2 hours,which was (310.4 ± 106.3) mL,(365.3 ± 142.8) mL respectively(t =2.142,P =0.035).The Visual Analog Scale for pain (VAS pain) was (2.8 ± 1.8) in group A and (4.1 ± 1.9) in group B,respectively (t =3.252,P =0.002).The gastrointestinal function recovery mean time of group A was significantly shorter than that of group B (12.5 h versus 16.0h,t =2.771,P =0.007).And the postoperative febrile morbidity was significantly lower in group A than in group B(8.5％ versus 25.5％ ;x2 =4.918,P =0.033).The patients with chronic pelvic pain followed up after operation was 3 versus 12,and the difference was significant (x2 =5.143,P =0.026).There were no differences in neonatal Apgar score at 1 minute,birth asphyxia and wound healing rates.Conclusion ECS plus forceps can be safely used for repeated cesarean section,with the advantages of less operation time,less bleeding volume,lower postoperative morbidity,and fewer complications than TCS.

OBJECTIVE: To investigate the efficacy of combined medical treatment on auditory neuropathy spectrum disorder and the effect of related factors on the prognosis. METHOD: Eleven cases (22 ears) diagnosed as auditory neuropathy spectrum disorder using multiple criteria including pure tone auditory threshold, impedance audiometry, acoustic reflexes, distortion products otoacoustic emission (DPOAE) and auditory brainstem response (ABR) were subjected to combined medical treatment . Eleven auditory neuropathy spectrum disorder patients diagnosed during the corresponding period but refused treatment were selected as control group. The change of pure tone auditory threshold and speech discrimination score after treatment or follow-up were evaluated for both 2 groups, and the relationship between the patients' gender, age, accompanying symptoms and curative effect were also analyzed. Data were analyzed by SPSS 19.0 statistical software using pared-sample t-test, independent-sample test and Pearson's chi-square test. RESULT: The effective rate of combined medical therapy was 59.09% (13/22) in the therapy group. PTA levels before and after-treatment were (53.92 +/- 18.86) dB HL and (47.44 +/- 14.98) dB HL respectively in 22 ears with the combined medical therapy, the improvement of which showed statistically significance (t = 5.20, P < 0.05). No obvious hearing change was noted in the 11 patients who refused therapy (P > 0.05). Speech discrimination score before and after-treatment were (29.20 +/- 25.80)% and (41.60 +/- 22.90)% respectively for the treatment group. The average improvement of speech discrimination score was (12.40 +/- 13.80)% with statistically significant difference (t = 4.02, P < 0.05). Patients accompanied with tinnitus had relatively poorer effect compared with individuals without tinnitus (t = -3.85, P < 0.05). Age is negatively correlated with the prognosis (r = -6.72, P < 0.05). Gender had no effect on the prognosis (P > 0.05). CONCLUSION The combined medical therapy with glucocorticoids helps improving the pure tone auditory threshold and speech discrimination score of auditory neuropathy spectrum disorder. In light of our findings we support the combined medical therapy as an option for patients with auditory neuropathy spectrum disorder.
Adolescent ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Hearing Loss, Central ; drug therapy ; Humans ; Infant ; Male ; Treatment Outcome ; Young Adult

Objective To assess the correlation between magnetic resonance imaging (MRI)and clinical staging of pelvic organ prolapse (POP)by using pubococcygeal line (PCL)and midpubic line (MPL)respectively.And to determine which(MRI)reference line for staging pelvic organ prolapse had the highest agreement with clinical staging.Methods A retrospective study of 32 women with pelvic organ prolapse who underwent dynamic pelvic MRI from Jan 2013 to May 2013 was conducted.One radiologist staged descent on MRI for each pelvic compartment (anterior,middle,posterior),using PCL and MPL lines.Agreement between MRI and clinical staging was estimated respectively.Results Thirty-two women were included.Agreement between clinical and MPL staging was morderate in the anterior (κ=0.44,SE=0.13)and middle compartment (κ=0.46,SE=0.12),but fair in the posterior com-partment (κ=0.23,SE=0.10).Agreement between clinical and PCL staging was poor in all compartments of pelvic.Conclusion MPL appeared more reliable and simple than the PCL for the evaluation of pelvic prolapse on MRI.

Objective To evaluate the performance of serum small dense low-density lipoprotein cholesterol(sdLDL-C)kit using enzymic method and evaluate the relationship with the severity of coronary heart disease.Methods Performance verification methodology. The analytical performance consisted of accuracy, precision and linearity of serum sdLDL-C kit using enzymic method was assessed. One hundred and twenty healthy persons were recruited to establish serum sdLDL-C reference interval. Two hundred and twelve patients underwent coronary angiography were enrolled in the study.Among them 110 cases were positive for coronary angiography, where as 102 cases were negative. We examined serum levels of sdLDL-C in 110 patients with positive angiography, 102 patients with negative angiography and 120 healthy volunteers. Positive group was classfied into severe group(Gensini score>30) and mild group (Gensini score≤30).Results The accuracy and precision of sdLDL-C examination were in compliance with manufacturer′s statement and there was a good linear correlation(Y=0.9937X-0.1063,R2=0.99) in range of 0.06-2.45 mmol/L. The reference interval of sdLDL-C was 0.15-0.97 mmol/L and without gender and age specificity. The level of sdLDL-C was higher in positive angiography group than in negative angiography group and healthy control group(P<0.01). The level of sdLDL-C was higher in severe group than in mild group(P<0.05). Binary stepwise regression analysis demonstrated that sdLDL-C was independently associated with the severity of coronary heart disease(OR=3.101,P<0.05).ConclusionsExperiment data demonstrated that serum sdLDL-C kit using enzymic method has good performance in the accuracy, precision and linearity. SdLDL-C that plays an important role in the occurrence and progression of coronary heart disease, is an independent important risk of the severity of coronary heart disease.

Objective To assessed the expression of inducible costimulator(ICOS)on peripheral blood and joint fluid CD4,CDS,CD45RO T cells and B cells in rheumatoid arthritis(RA).Methods Expression of ICOS and ICOS/CD45RO on peripheral blood and joint fluid CD4~+CD8~+T cells and ICOS ligand(ICOSL)on CD19 B cells from RA patients and healthy volunteers were determind by three-color flow cytometry.Compar- ision with active and inactive RA,initial and relapsed RA had been done.Results Joint fluid CD4 and CD8 T cells expressing ICOS,ICOS/CD45RO were significantly increased than peripheral blood in RA patients and healthy subjects.Joint fluid B cells expressing ICOSL were significantly reduced than peripheral blood in RA patients.Meanwhile,peripheral blood B cells expressing ICOSL were significantly reduced in active RA than inactive RA patients.Conclusion Hyperexpression of ICOS and ICOS/CD45RO on joint fluid CD4 and CD8 T cells and lowexpression of ICOSL in B cells from RA patients,expecially in active RA may contribute to the local immunopathological roles and joint destructions in the pathogenesis of RA.

Colitis, Ulcerative ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Psoriasis ; complications ; drug therapy ; Pyoderma Gangrenosum ; drug therapy ; etiology

Objective To investigate the protective role of FDP to STZ induced islest apoptosis and the potential mechanisms.Methods The pancreases of the rats were treated to collect islets cells.The cells were incubated with STZ with/or FDP.Cell morphology,insulin secretion,HO-1 activity,CO content,SOD activity,GSH-px activity,iNOS activity were examined.No conetent and apoptotic percentage was detected.Results HO-1 activity and CO content of the normal control group were low.STZ induced a significant decrease of cell activity and insulin release,flow cytometry analysis showed that apoptotic percentage of islet cells remarkably increased following the addition of STZ,FDP obviously improved the islets cellular activity damaged by STZ,basic amount of insulin secretion and stimulated by high glucose were improved(P

This study aimed to design a pair of primers for amplifying internal transcribed spacer 2 region which was used to identify Gastrodia elata through optimizing of DNA extraction and PCR amplification process. Two sequences are used for research object by amplification of universal primers. Design three pairs of specific primers by Primer Premier 5.0 and select the highest specificity through the study of 22 samples. The results showed that identification efficiency of the primer named TM2F-2R is as high as 90.9% when Annealing Temperature is equal to 54 degrees Celsius. Therefore, TM2F-2R can be used as primers ITS2 sequences of G. elata, this article provides a set of accu-rate and stable identification methods for G. elata in the molecular identification.