Objective To explore the correlation factors of hospital stay and hospitalization costs among patients with acute ischemia stroke (AIS). Methods The clinical data of the patients with first diagnosis of AIS at Peking University Third Hospital in China from January 1 , 2012 to December 31 , 2012 were retrospectively analyzed to investigate the correlation factors of hospital stay and hospitalization costs using univariate analysis and multiple regression analysis. Results The study involved 496 patients, with a mean age of 63.38 years (range:26~88 years). Multivariate regression analysis showed the significant impact factors for LOS were age, pneumonia, the total score on NIHSS, medication for secondary prevention and stroke subtype. The significant impact factors for cost of hospital stay were payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention. Conclusions Age, pneumonia, the total score on NIHSS, stroke treatment and its subtypes are the significant impact factors affecting hospital stay. Payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention are the significant impact factors affecting costs of hospitalization.

Objective: To study the intrarenal expression of Fas ligand (FasL) and T cell intracellular antigen-1 (TIA-1) protein during acute rejection after renal transplantation. Methods: Immunohistochemical technique was used to detect FasL and TIA-1 expression in 32 transplanted renal samples,2 living donor kidneys and 8 adjacent samples of renal cancer (including 14 acute rejection samples, 15 chronic and 13 non-rejection ones according to Banff criteria). Results: The positive FasL staining was observed mainly in cytoplama of renal tubule epithelia, and the positive rate was significantly higher in acute rejection samples than in others(P<0.01). TIA-1 was found in both tubular epithelial cells and interstitial infiltrating lymphocytes, occasionaly in small arterial endothelial cells. The positive staining rate of TIA-1 acute rejection samples was also higher than those of other samples(P<0.05). The expression of FasL and TIA-1 in acute rejection samples was positively correlated with the severity of tissue damages. Conclusion: Over expression of FasL and TIA-1 in acute rejection renal allograft tissues may indicate the activation of T cells,and its detection may be helpful for early diagnosis of acute rejection.

Objective To explore the best safe dose of warfarin in patients with heart valve replacement.Methods One hundred patients with heart valve replacement were selected.They were divided into ≤60 kg group(47 cases) and ＞ 60 kg group(53 cases),postoperative time ≤3 months group (39 cases) and postoperative time ＞ 3 months group(61 cases),international normalized ratio(INR) ＜ 1.5 (group Ⅰ,23 cases),INR 1.5-2.5 (group Ⅱ,66 cases),INR ＞ 2.5 (group Ⅲ,11 cases).The dose of warfarin,plasma thrombus precursor protein(TpP) and D-dimer(D-D) were compared.Results The dose of warfarin was (2.90 ± 1.11) mg in ≤ 60 kg group and (2.47 ± 0.18) mg in ＞ 60 kg group,and there was significant difference between two groups (P ＜0.05).There was no significant difference in the dose of warfarin between postoperative time ≤3 months group and postoperative time ＞ 3 months group (P＞ 0.05),but there was significant difference in TpP and D-D [(6.32 ± 0.01) mg/L vs.(4.97 ± 0.81) mg/L,(879 ± 52) μ g/L vs.(151 ± 35) μ g/L] (P ＜ 0.05).The incidence of complications was 2.6％ (1/39) in postoperative time ≤3 months group,which was lower than that in postoperative time ＞ 3 months group[18.0％(11/61)],and there was significant difference between two groups (P＜ 0.05).There was significant difference in the dose of warfarin and D-D between group Ⅰ and group Ⅱ,group Ⅲ [(2.56 ±0.21) mg vs.(2.94 ±0.57),(3.07 ±0.44) mg,(793.92 ±42.73) μg/L vs.(100.96 ± 21.56),(61.08 ± 20.34) μg/L](P＜ 0.05),but there was no significant difference between group Ⅱ and group Ⅲ (P ＞0.05).There was significant difference in TpP among three groups [(8.50 ± 0.63),(5.42 ± 0.78),(3.16 ± 0.38) mg/L in group Ⅰ,Ⅱ,Ⅲ respectively] (P ＜ 0.05).Conclusion With warfarin dose and the incidence of complications,the best dosage of wadarin is (2.94 ± 0.57) mg; the optimal range of INR is 1.5-2.5.

Objective To explore the values and relationship among the contents of thrombus precursor protein(TpP)and plasma D-dimer(D-D),complications after mechanical heart valve replace-ment and their correlation with international normalized ratio(INR)in anticoagulation therapy and monito-ring.Methods A total of 150 patients with mechanical heart valve replacement were enrolled.TpP,D-D, INR,other indicators and complications were compared to draw conclusions.Results There were signifi-cant differences in TpP among the groups(P<0.0083).Significant differences in D-D among the postop-erative group(100.96 ±61.56),thrombosis group(17.78 ±5.94)and control group(5.97 ±1.58)were observed(P<0.0083).Significant differences in INR among the postoperative group(1.65 ±0.34),hem-orrhage group(2.22 ±0.65)and control group(1.11 ±0.10)were observed(P<0.0083),but the effec-tiveness of INR monitoring for determining the state of thrombosis was limited to a certain extent.Conclu-sion TpP and D-D examination can facilitate monitoring after mechanical heart valve replacement,and it has a certain guiding significance for determining anticoagulation therapy and monitoring of complications after mechanical heart valve replacement.

Objective To evaluate the feasibility of CT staging for esophageal cancer. Methods A retrospective analysis of 304 patients treated,from Jan. 1996 to Dec. 1998 chiefly with radiotherapy(126 conventional radiotherapy,55-65 Gy/27-35 fx/5.5-7.0 w;178 late-course accelerated hyperfractionated radiotherapy ,55-60 Gy/33-36 fx/ 4.5 -5.5 w)complete with CT data before treatment was done. The long survival was compared with pre-therapy CT findings and CT staging. ResultsThe survival rate of stage T1+T2 was very significantly different from those lesion with stage T3,T4(? 2=12.90,P0.05).The survival rates of patients positive for lymph nodes or distant metastasis were lower. Conclusion CT staging is quite optimal for non-operable esophageal cancer in clinical staging,as it is conducive to predict the prognosis.

Objective To assess the evolution of gastric epithelial dysplasia (GED). Methods We reviewed the history of 239 of patients with gastric dysplasia diagnosed by endoscopic biopsy, and 195 were followed up for 61. 37 months. Results Among 239 cases of dysplasia (261 lesions) , there were 119, with mild dysplasia, 77 with moderate dysplasia, and 43 with severe dysplasia. The gastric dysplasia lesions are mainly in lesser curvature, and its endoscopic appearance mostly is localized erosion. In the follow - up group, regression of dysplasia was demonstrated in 86. 36% , 81. 25% , and 47. 62% of mild, moderate and severe dysplasia respectively. Progression to gastric cancer was detected in 8. 18% , 15. 63% , and 72. 09% of mild, moderate, and severe dysplasia, respectively. The relative risk (RR) of mild, moderate, severe dysplasia was 1. 96, 3. 74, and 17. 25 respectively. Conclusion Carcinomatous evolution of GED increases proportionally with its histological grade. Gastroscopy biopsy follow-up should be held up for all grades of GED, especially, in high grade GED, gastroscopy and biopsy should be taken as soon as possible.

Objective To evaluate the clinicopathological characteristics of early gastric carcinoma for prognosis and the long term consequences of gastrectomy for quality of life in the aged. Methods The clinicopathological features and late postoperative complications by follow up study for 71 patients during 1973 1999 with early gastric cancer were reviewed by using hospital records. Results Forty six cases(64.8%) were diagnosed by routine gastroscopic checkup. 56 cases out of 71 (74.6%) were mucosal cancer without lymph node metastasis, 18 cases were submucosal cancer with lymph node metastasis in 2 cases. By histological study, we found that 32 lesions (45.1%) were located at the antrum, differentiated tubular adenocarcinoma was found in 43 cases, and multiple primary carcinoma in 5 cases and gastric stump cancer in 3 cases. The disorders of gastric stump included anastomotic gastritis, empting disturbance, erosion, ulcer, reflux esophagitis were found in 31, 7, 6, 4 and 3 cases, respectively. Fourteen patients showed weight loss and 9 showed anemia. Patients with proximal gastrectomy suffered more from disoders than the patients with distal gastrectomy. Conclusions Our results suggest that special attention should be given to the patients with chronic atrophic gastritis diagnosed by routine gastroscopy. Lymph node metastasis, multiple primary cancer and gastric stump cancer might affect the prognosis. Our results support the fact that the incidence of disorders of gastric stump are high; and the surgical treatment with gastroscopic procedure is recommended for the mucosal cancer in order to improve the patients' quality of life.

Objective To evaluate the importance of clinical screening and follow up by direct colonoscopy for colorectal cancer at an early and curable stage. Methods There were 2 196 elderly people aged between 60 to 89 years. The clinical screening by direct colonoscopy was performed according to the protocol. 1 740 of 2 196(79.2%) patients were followed up every year. Results Fifty two elderly persons were found to be colorectal cancer patients by colonoscopy, with the detectable rate being 2.4%. Nineteen were diagnosed early stage colorectal cancer, accounting for 36.5% of the detected colorectal cancer. Nine among the followed up cases were detected early colorectal cancer, accounting for 45 0% of the detected colorectal cancer. The resectable rate and the 5 year survival rate was 97 7% and 80 9% for colorectal cancer, respectively. 98 9% of the cecum intubation cases was successful. The incidence of complication for colonoscopy was 0 05%. Conclusions By clincal colonscopy screening and follow up study for colorectal cancer and precancerous changes in the elderly, the patients with adenomatoid polyps were early diagnosed and treated, so it raised the detectable rate of early colorectal cancer and the level of grade prevention of colorectal cancer.

[Objective] To evaluate the efficacy and short-term results of selective expansive open-door laminoplasty(ELAP).[Method] From June 2005-June 2006,a total of 102 pataents with cervical spondylotic myelopathy(CSM)were enrolled in this study.Forty-four patients underwent ELAP.Fifty-eight patients undergoing conventional C3~7 ELAP served as controls.The clinical results and radiological examinations of both groups were evaluated at 12 month after surgery.[Result]There was no significant difference in recovery rate of Japanese Orthopaedic Association(JOA)scores.The incidence of axial symptoms in the selective ELAP group was significantly lower than those in the C3~7 ELAP group(P

To study the significance of detection of K ras mutation in stool samples in the diagnosis of large intestinal cancer, stool and local tissue samples were collected from consecutively diagnosed patients, among them 23 cases suffered from large intestinal cancer, 20 cases from colorectal adenomatoid polyps and 20 healthy subjects. DNA was extracted from both the stool and the tissue, K ras gene mutations at the first and second base of codon 12 were studied by allele specific mismatch method in both of them. The results showed that K ras mutation rate in large intestinal cancer was 56 52%(13/23), which was much higher than 5%(1/20)in healthy subjects( P 0 05). There was a 92 31%(12/13)incidence of K ras mutation at the second base of codon 12 in large intestinal cancer. The results of detecting the K ras mutation were highly identical in both the stool and the tissue ( P