OBJECTIVE To analyze and compare the value of c-reactive protein(CRP) and body temperature in the infection diagnosis and severity of infection among the patients with malignant hematological disease.METHODS According to the microorganism detection and application of antibiotics,we divided the 119 patients into infection group and noninfection group from May 2004 to May 2005 in our ward.CRP and temperature of the patients were measured and.RESULTS There were 88 cases in the infection group and 31 cases in the noninfection group.The CRP plasma concentration had significant difference between too groups(P

Objective To explore the value and criteria for primary tumor resection in patients with stage Ⅳ rectal cancer. Methods The clinical data were retrospectively analyzed for 53 patients with stage Ⅳ rectal cancer undergoing primary tumor resection. Results All patients were graded according to Eastern Cooperative Oncology Group (ECOG) performance as status 1. Seventeen of 53 patients (32%) received palliative resection. Thirty-six patients received adjuvant radiotherapy and/or chemotherapy. The median follow-up was 14 months. Forty-seven patients had complete resolution of their symptoms related to the primary rectal cancer for a year. The median survival was 16 months and 2-year overall survival of 24.5%. On multivariate analysis, chemotherapy was a determinant of prolonged survival (P=0.046). Conclusions Resection of primary tumor in patients with stage Ⅳ rectal cancer can improve the quality of life. Patients who have a good performance status, minimal metastatic disease and normal preoperative liver function tests should undergo resective surgery and aggresive systemic chemotherapy.

A gap is found between the existing quality of care,and social expectations and the PDCA model.Peking University People's Hospital applied the quality control circle in building a supervision platform for medical quality and sustained improvement of civilized services.This study demonstrated the efforts in this regard made by the hospital,and the major outcomes of the platform in its 6-year practice in identifying service defects,optimizing service processes and sustained improvement of medical services.In addition,it also shared insights on enhanced real-time supervision,standardized management,and long-term mechanisms of the hospital.

BACKGROUND:Classical deltopectoral approach leads to a great injury to soft tissues. It is difficult to lay the steel plate on the lateral side. The steel plate is frequently laid on the anterolateral side of humerus. Fixed position is not ideal.
OBJECTIVE:To evaluate the safety and feasibility of lateral deltoid-splitting approach in treatment of proximal humeral fractures.
METHODS:From August 2008 to August 2013, 114 patients with fracture of surgical neck of humerus, who were treated in the Department of Orthopedics, Yan’an Hospital Affiliated to Kunming Medical University in China, were enrol ed in this study. They were treated with locking compression plate, and assigned to deltoid splitting approach group and deltopectoral approach group (n=57). Surgical trauma, fracture healing, curative effects, functional recovery and Constant shoulder score were compared between the two groups.
RESULTS AND CONCLUSION:Al patients were fol owed up for at least 8 months. Compared with the deltopectoral approach group, the proximal humeral fractures were healed as scheduled in the deltoid splitting approach group, and the anteflexion, abduction, shoulder lifting of the shoulder joint, and sensation of lateral skin of the upper arm were not impacted. No significant difference in Constant shoulder score was detectable between the two groups (P>0.05), which suggested that deltoid splitting approach for treating the proximal humeral fractures was safe and feasible. In addition, in accordance with the Neer’s classification system, the excellent and good rate in the deltoid splitting approach group (91%) was significantly higher than that in the deltopectoral approach group (75%) (P<0.05). Therefore, the deltoid splitting approach can be used as the first choice for the treatment of proximal humeral fractures.

Objective To investigate the effect of intermedin (IMD) on renal ischemia/ reperfusion (I/R) injury after the up-regulation of IMD. Methods A total of 24 healthy Wistar male rats were randomly divided into four groups,sham-operated group,I/R group,IMD gene transfection +I/R group and empty plamid +I/R group.All the animals were killed at the end of 24 h of reperfusion.Histological changes and renal function were estimated.The expression and site of IMD were determined by Immunohistochemistry method,semi-quantitative RT-PCR and Western blotting.The protein expressions of endothelin 1 (ET-1),tumor necrosis factor αt (TNF-α) were detected by Western blotting. Results Compared with sham-operated group,tubulointerstitial pathological injury was significant aggravated in I/R group (7.6±2.3) and empty plamid +I/R group (7.0±1.8),and such injury was improved in IMD+I/R group (1.5±0.8) (P＜0.05).Compared with I/R group and empty plamid +I/R group,the renal dysfunction of IMD +I/R group was obviously lessened [BUN:(7.73±1.03) mmol/L vs (10.13±2.14) mmol/L,(9.77±1.92) mmol/L; Scr:(58.50±3.27) μmol/L vs (80.33±7.15) μmol/L, (75.67±7.58) μmol/L,all P＜0.05].IMD expression was weak in the plasma of tubulointerstitial cells in sham-operated group,and was up-regulated in I/R group. Compared with I/R group, immunohistochemical IMD expression increased obviously (262.03±67.89 vs 175.57±48.06,P＜0.01).The mRNA expression of IMD in IMD+I/R group was up-regulated significantly by 60.7％,66.1％ and the protein expression of IMD in IMD+I/R group increased significantly by 51.4％,55.9％ as compared to I/R and empty plasmid +I/R group.Meanwhile,the protein expressions of ET-1 and TNF-αt in IMD+I/R group were obviously lower compared with those in I/R group (ET-1:0.08±0.02 vs 0.17±0.02; TNF-α:0.21±0.04 vs 0.35± 0.02,all P＜0.05). Conclusion IMD gene transfected into kidneys of rats prior to I/R surgery can attenuate the over-expressions of both ET-1 and TNF-o in I/R injured rat kidneys as well as the damages to the structure and function of the kidneys.

BACKGROUND: Random flap as a primary means of wound healing, is widely used at present, its blood circulation to establish the situation is also researched a lot, but not yet the system of random skin flap perfusion were observed and measured. In addition, the timing of pedicle division of a pedicle flap random is also a hot topic, but not yet a mature clinical testing method has been discovered to determine the best timing.OBJECTIVE: By means of laser Doppler blood perfusion imaging, this study was designed to dynamically observe random flap microcirculation, to understand the changes on random flap blood flow, and to determine the best timing of pedicle division. METHODS: A total of 18 cases were divided into traditional pedicle division group and early pedicle division group. Pedicle flap blood perfusion values were statistically measured immediately after surgery, at 3, 7,11,15, and 19 days after surgery, before division, immediately after division, and at 24 hours after pedicle division, 8-9 phases in total.RESULTS AND CONCLUSION: Distal blood perfusion value was increased with the time prolongation in both groups; while, the blood perfusion in various time phases was significantly different from that after surgery (P < 0.05); but, the blood perfusion was decreased immediately after surgery, which was still significantly compared with traditional pedicle division group (P< 0.05). There was no significant different in blood perfusion between early pedicle division and immediate after surgery of pedicle division (P > 0.05), but there was significant difference between 24 hours after pedicle division and immediate after surgery of pedicle division (P< 0.05). Blood perfusion values were less changed in both groups (P> 0.05). The ratio of both groups peaked before pedicle division and then gradually decreased after pedicle division. The best timing of pedicle division was the ratio of 1.2.

BACKGROUND: Pentoxifylline (PTX), as an effective drug to improve blood rheology, has been used as a vasodilator for the treatment of vascular diseases and peripheral vascular disease science 1960s. But the role of PTX on skin blood flow to improve flap survival remains still unclear. OBJECTIVE: Through the clinical application of PTX therapy, the dynamic observation of random flap to understand that the PTX can promote flap survival and improve blood circulation of flap. METHODS: A total of 39 patients (27 males and 12 females aging 7-54 years) with skin tissue defect undergoing random flap repairing were selected from Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University. The 39 cases were randomly divided into control group and drug group. Patients in the drug group were given intravenous injection of 250 mL PTX at day 2 after random flap operation, once a day, until 14 days after flap repairing surgery. On the first day after flap pedicle surgery, 250 mL PTX sodium chloride injection was intravenously given, once a day, until 7 days after flap pedicle surgery. The control group was not given PTX treatment. The value of blood perfusion (PU) was measured using laser-Doppler blood reperfusion image after flap transplantation, before and after pedicle division. RESULTS AND CONCLUSION: All 39 patients were completely cured and discharged, with no interruption experiments. Before pedicle division, PU value at distal flap in both drug and control groups were increased obviously, and the PU value in the drug group was significantly higher than control group (P < 0.05); after pedicle division, the PU value in the two groups were decreased, and there was no significant difference between the two groups (P > 0.05). Prior to pedicle division, the PU value of pedicle was gradually decreased and then increased in the drug group, and that in the control group was gradually increased. On the seventh day, the PU value of pedicle was stable in the drug group, and there was no significant difference between the two groups (P> 0.05); after pedicle division immediately, the PU values of pedicle were decreased in the two groups, and then the increase in the drug group was remarkable compared to control group (P < 0.05). Two sets of random flaps all survived, and skin defects were successfully repaired after pedicle division. PTX can markedly increase blood perfusion after random flap transplantation, promote flap survival and pedicle division in an early stage, and effectively shorten the healing time.

Objective To construct eukaryotic expression vector encoding rat IMD gene and deliver it into rat renal tissue via ultrasound-mircobubbles. Methods IMD gene was inserted into pCDNA3.1 ( + )between Hind Ⅲ and EcoRI enzyme sites. The recombinant plasmid designated as IMD-pCDNA 3.1 wasconfirmed by restrictive enzyme digestion and sequencing. Eighteen male Wistar rats were randomized into 3groups, which were treated with no transfection, empty vector transfection and IMD transfection, respectively, in renal tissue via ultrasound-microbubbles. RT-PCR and Western blotting were applied to detect the expression level of IMD. Results Enzyme- digestion and sequencing data showed that IMD-pCDNA 3.1 was correctly constructed. The differences in ALT, AST, BUN and SCr were not significant; No obvious damage in the glomerular, tubular and interstitial was observed in all the treated groups;Compared with non-transfection group and empty vector-transfection group, IMD mRNA and protein expression in IMD transgenic renal tissue were significantly increased. Conclusion IMD-pCDNA 3.1 expression vector was successfully constructed and well expressed in rat kidney.

Objective To ascertain the uranium concentrations and uranium isotopic ratios in drinking water in Xilingol League,the Inner Mongolia Autonomous Region.Methods Drinking water samples were collected in Xilingol League,the Inner Mongolia Autonomous.Region inductively coupled plasma mass spectrometry (ICP-MS) was applied to determine the concentration of uranium and uranium isotope abundance.Results The uranium concentrations in all samples were in the range of 2.73-18.9μg/L,with an average of 8.20 μg/L.Tbe234U/238U isotope ratio varied from 7.513 × 10-5to 3.003 × 10-4 and235U/238U from 7.196 × 10-3 to 7.391 × 10-3.The relative standard deviation (RSD) was less than 0.5％ for234U/238U and 0.2％ for235 U/238U.Conclusions The uranium concentration in samples collected from Dongwuqi was high than 15 μg/L,whih is the limit given by World Health Organization (WHO).The uranium in drinking water originates from the natural environment.The234U is enriched in drinking water.