Objective To evaluate the clinical application and significance of enzyme-linked immunosorbent assay(ELISA)for serologically diagnosing bullous dermatosis.Methods Serum Dsg1,Dsg3 and BP180 expressions were detected in 34 cases of pem-phigus,32 cases of bullous pemphigoid and 33 cases of non-bullous dermatosis by ELISA.Results The sensitivity and specificity of ELISA for detecting the bullous dermatosis antibody were 87.88% and 93.94% respectively.Conclusion The ELISA method has the diagnostic value on bullous dermatosis and the important significance in the disease classification.

Objective:To study the effects of glutamine on the rehabilitation and the immune function in patients with acute stroke. Methods: The study included 57 patients with cerebral ischemia and 29 patients with brain hemorrhage.Nutritional and immune function parameters were evaluated at admission and after 2 weeks following stroke respectively.Neurological deficit was also evaluated by the Chinese Stroke Scale at admission and after 28 days following stroke.The infective complications were investigated. Results:At the same duration after acute stroke,the extent of neurological deficit recovery was significantly lower in the control group than the glutamine group.The rate of the infective complications was significantly higher and it's duration was significantly longer in the control group than the glutamine group.The degree of nutriture and immune function deteriorating was significantly severer in the control group than the glutamine peptide group. Conclusion:Parenteral glutamine supplements is helpful for the rehabilitation and in preventing deterioration of nutrition status and immune function following acute stroke.

Objective To analyze the literature distribution and research status of osteoporosis in the elderly published in Chinese Medical Association journals.Methods The literatures of elderly osteoporosis published in Chinese Medical Association journals from 2008 to 2013 were collected.And the publication year,distribution,content,institution and region of the literatures were analyzed.Results From 2008 to 2013,there were 76 articles about osteoporosis in the elderly published in 22 kinds of journals of the Chinese Medical Association.Among these journals,the Chinese Journal of Geriatrics-published elderly osteoporosis articles occupied the most number [28 (36.8％)].There were 21 articles published mostly in 2013 (27.6％),secondly in 2009 (17 articles,22.4％) and 2012 (12 articles,15.8％).The province or city that published more than 10 articles was Beijing (18 articles,23.7％),Zhejiang (13 articles,17.1％),Shanghai (10 articles,13.2％) and Guangdong (10 articles,13.2％).The institution that published most articles was Beijing Jishuitan Hospital (4articles,5.3％).The main contents of these literatures included the influencing factors,diagnosis,treatment strategy,bone metabolism and surgery treatment for elderly osteoporosis.Conclusions Chinese Medical Association journals are the important source to acquire osteoporosis literature for the medical workers.The distribution of journal is relatively concentrated,but the distribution of authors,institution is dispersed.Chinese Journal of Geriatrics publishes the most number of articles.The research of osteoporosis has attracted more attention.

Objective To provide evidence for the rational use of antibiotics.Methods Analyze on the results of pathogen detec-tion and antibiotic susceptibility tests for the patients in the hospital from January 2013 to December 2013.Results There were 2 111 strains of pathogenic bacteria detected in 2013,among which the Gram-negative bacteria accounted for 75.5%(1 594/2 111). The main species were Klebsiella pneumonia,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae,Pseudomonas aerugi-nosa,Klebsiella oxytoca.Gram-positive bacteria accounted for for 20.3%(428/2 111),the main species of which were Streptococcus pneumonia,Staphylococcus aureus,Staphylococcus aureus and Enterococcus faecalis.There were 89 strains of fungi,which accoun-ted for 4.2%(89/2 111).The antibiotic susceptibility tests showed that Klebsiella pneumoniae′s drug resistance to 13 kinds of anti-biotics were all less than 25.00%.Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa displayed highly resistance to cephalosporin antibiotics while sensitive to Cefperazone-Sulbactam.The antibiotic resistance of Gram-positive bacteria to macrolide were greater than 70% while that to Vancomycin was 0.0%.Staphylococcus aureus and Staphylococcus epidermidis were highly re-sistant to penicillin.Conclusion The monitoring of bacterial resistance in hospital contributes to the rational use of antibiotics and avoiding the formation and spread of drug-resistant strains.

Objective To explore the risk factors for healthcare-associated infection (HAI)caused by Candidain a hospital.Methods 64 patients with healthcare-associated(HA)Candidainfection in a hospital between January 201 1 and October 2013 were selected as case group,and 64 patients without HACandidainfection during the same period were as control group,clinical data of two groups of patients were analyzed.Results The mainCandidacau-sing HAI were Candidaalbicans(68. 75% ),followed by Candidatropicalis(15. 62% ),Candidaglabrata (9.38% )andCandidakrusei(6.25% ).The major infection sites were respiratory tract(67.19% ),urinary tract (18.75% )and digestive tract(10.94% ). Univariate analysis showed the risk factors for HA Candidainfection were age,length of hospital stay,diabetes,and malignant tumor and so on;multivariate logistic regression analysis showed that important risk factors for HACandidainfection were age(OR95% CI:2.57-33.67),length of hospi-tal stay(OR95% CI:2.17-25.37),malignant tumor(OR95% CI:1.04-15.23),chemotherapy(OR95% CI:1.76-20.63),and use of respirator(OR95% CI:4.67-96.37).Conclusion Risk factors for HACandidainfection are complicated,in order to reduce the incidence of HA Candidainfection,risk factors should be considered,and preventive measures according to risk factors should be made.

As a node between the skull and the spine, atlantoaxial joint plays a pivotal role in the maintenance of head and neck activities, as well as the connection between the brains and the spine. The biomechanical characteristics of stlantoaxial joint, together with traumatic factors, contribute to determine the site, type and character of atlantoaxial joint fracture and dislocation, they also affect the treatment of atlantoaxial joint injury. With the materials technique development and accumulated experience of clinical operations, various types of new implants are increasing and used for clinical practice, accordingly the surgical approach and therapy regimen of atlantoaxial disease have been greatly enriched. At present, the use of implant mainly aims to promote the atlantoaxial fusion or enhance the connection and fixation between atlantoaxial joints. However, the head and neck activities are also limited simultaneously while the implant enhances the atlantoaxial joint stability. Further studies require to handle the correlation between joint stability and joint flexibility and to maximize the physiological function recovery of atlantoaxial joints when ensuring the atlantoaxial joint stability.

Objective To investigate clinical significance of positive antineutrophil cytoplasmic antibodies (ANCA) in diagnosis for vasculitis or other diseases. Methods From January 2005 to December 2008, 104 patients with positive ANCA detected by enzyme-linked immunosorbent assay (ELISA) in People's Hospital of Peking University were randomly selected and their clinical features and diagnoses were analyzed retrospectively. Results Among 104 ANCA-positive patients, 22 were diagnosed as vasculitis and 13 as ANCA-associated vasculitis, and 82 (78. 8% )were diagnosed as non-vasculitis including 40 of connective diseases such as systematic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and 42 of non-connective diseases with the most common of ulcerative colitis. According to the results of ANCA tests by ELISA, ANCA-positive patients could be divided into those with proteinase 3 (PR3)-positive and myeloperoxideaso (MPO)-positive. More organs were involved in MPO-positive patients (n =48 ) than that in PR3-positive ones ( n = 49), and more frequent involvement of the kidneys and less frequent involvement of the gastrointestinal tract in MPO-positive than those in PR3-positive ones (P < 0. 01 ). As compared to those with non-vasculitis, more organs (2. 28 organs vs. 3.55 organs in average) were involved in patients with vasculitis (P <0. 01 ) and more frequent involvement of the upper or lower respiratory tracts and the kidneys in vasculitis patients ( P <0. 01 or <0. 05, respectively). Elevated leukocyte count and accelerated erythrocyte sedimentation rate (ESR) were also more common in vasculitis patients than those in non-vasculitis ones (P <0. 01 and P <0. 05, respectively). Positive ANCA combined with number of organs involved, clinical manifestations and other laboratory findings, its positive predictive value (PPV) in diagnosis for vasculitis can be improved. Conclusions Spectrum of disease in patients with positive ANCA was varied. Diagnostic value of positive ANCA in diagnosis for vasculitis can be improved if combined with comprehensive analysis of their clinical features and laboratory examinations.

Objective In order to increase significantly the discriminatory potential of Y-STR systems available to the forensic community , We have developed and validated a four-color fluorescence multiplex PCR system consisting of 7 male-specific and polymorphic Y-STRs. Methods We designed three sets of constant primers chimerited into three groups of 7 Y-STR's specific primers and utilized fluorescence- labeled these three sets of constant primers to amplified simultaneously 7 Y-STRs in a reaction tube. Allele and haplotype frequencies at these Y-STRs were screened by ABI PRISM310 Genetic Analyzer and analyzed by Genotyper software. Results Following optimization of the polymerase chain reaction , DYS434, Y-GATA-A10,DYS531, DYS557 , DYS456 , DYS444 and DYS448 in a sample of 120 unrelated males , showed4, 5, 5, 8, 8, 6,7 alleles respectively. A total of 101 different haplotypes was identified,of which 89 (88. 11% ) were found in single individuals. The overall haplotypes diversity reached 0.9958. To the one case of mixture stains, our multiplex system drawn conforming conclusion comparing to the result of Y-STR genotypes in suspect's blood sample. Conclusion Our results show that the multiplex system of 7 Y-STR will be very powerful for establishing Y-STR database, the paternity testing and mixture stains identifying.

Procalcionin ( PCT) is a soluble protein liberated into the circulation of patients in response to severe systemic in-fection, in particular by bacterial infection.It is used as the most accurate biomarker for the diagnosis of sepsis.This review briefly de-scribes the induction of PCT, the comparison of PCT and other markers of sepsis, the application of PCT measurement in confirmation or exclusion of diagnosis of sepsis, the assessment of severity and treatment effectiveness of systemic infection, the application of PCT in guiding individual and specific treatment of antibiotics, and the anormaly situation of elevated levels of PCT in patients who do not have sepsis.

Objective To compare the short-term efficacy between da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.Methods Database including PubMed,EMBASE,the Cochrane Library,Medline,the China National Knowledge Infrastructure (CNKI),Wanfang Database,VIP and China Biomedicine were searched with the key words of gastric cancer,gastrectomy,da Vinci surgical system,laparoscopic,laparoscopy,胃癌,胃切除术,达芬奇机器人手术系统and腹腔镜.Literatures published between May 2002 and March 2014 were retrieved.Related controlled trials containing the clinical efficacy of da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.Patients receiving da Vinci robotic surgery and laparoscopic surgery were allocated into the robotic group and laparoscopy group,respectively.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using weighted mean difference (WMD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Eleven literatures including 3 698 cases were enrolled in the study.There were 953 patients in the robotic group and 2 745 patients in the laparoscopic group.There were significant differences in the operation time,volume of intraoperative blood loss,time of postoperative flatus,time of first oral intake and duration of postoperative hospital stay between the 2 groups (WMD =51.23,-36.96,-0.24,-0.26,-1.11,95％ CI:28.01-74.46,-61.28--12.65,-0.42--0.06,-0.39--0.14,-1.92--0.29,P ＜ 0.05).There was no significant difference in the number of lymph nodes resected,the distance to proximal and distal resection margin and overall incidence of postoperative complications (WMD =1.63,0.21,0.06,RR =1.11,95％ CI:-0.49-3.76,-0.65-1.06,-0.13-0.25,0.90-1.37,P ＞ 0.05).Conclusion Da Vinci robotic radical gastrectomy for gastric cancer is safe and feasible,with the advantages of minimal invasion and rapid postoperative recovery.