OBJECTIVE: To analyze the effects of social and psychological factors on rehabilitation status of end stage renal disease (ESRD) patients under peritoneal dialysis. METHODS: From August in 2005 to March in 2007, 171 patients experienced peritoneal dialysis were diagnosed at the Center of Peritoneal Dialysis, Department of Nephrology, First Hospital, Peking University, including 66 males and 105 females, aged (60±13) years, with an average dialysis time of 22.8 months. They were studied with questionnaires and interview. Rehabilitation status was investigated from two aspects of activity and participation by Karnofsky activity index, Social Dysfunction Screening Scale. Hamilton depression and anxiety scales, Medical Coping Modes Questionnaire and Social Supporting Rating Scale were used to investigate social and psychological factors.RESULTS: A total of 200 questionnaires were handed out and 171 (85.5%) of them were drawn in. 134 patient had normal activity status, 78.4% of them had Dysfunction and 129 patients (75.4%) had normal social function status. Forty-two (24.5%) of patients had the symptom of anxiety, 15 (8.2%) had depression. The score of "Acceptance-Resignation" was significantly higher in this group than patients with other chronic diseases. There were no significant differences in scores of "Confrontation" and "Avoidance". Activity of rehabilitation outcome and participation index served as dependent variable, whereas depression and anxiety, coping mode and social supporting as independent variable. Using multiple stepwise regression analysis, factors that affected patient rehabilitation were found, including depression, utilization of social support and the facing coping mode. CONCLUSION: Depression, utilization of social support and the facing coping mode have important effects on patient rehabilitation.

Objective To investigate the gene mutation of epithelial growth factor receptor(EGFR) and the expressions of hu‐man epiderma1 growth factor receptor 2(HER‐2) and vascular endothelial growth factor(VEGF) in lung adenocarcinoma and their relationships with the clinical pathological factors .Methods ARMS‐PCR method was used to detect the gene mutation of EGFR in 49 lung adenocarcinoma specimens and 10 normal tissue specimens .Immunohistochemical method was also used to detect the ex‐pressions of the HER‐2 and VEGF in them .Results (1) The mutation rates of EGFR and the positive rates of HER‐2 and VEGF in lung adenocarcinoma were significantly higher than those in the normal tissues(P< 0 .01) .(2) The occurs of EGFR mutation were correlated with sex and the smoking habit(P<0 .05);but not correlated with age ,the size of tumor ,differential ,lymph nodes metastasis ,TNM stages and pleural invasion(P>0 .05) .The HER‐2 and VEGF protein expressions in lung adenocarcinoma were correlated with differential ,the size of tumor ,TNM stages ,lymph nodes metastasis and pleural invasion(P<0 .05);but not correla‐ted with sex ,age ,and the smoking habit(P>0 .05) .(3) The expressions of HER‐2 and VEGF protein in the lung adenocarcinoma were positively correlated with each other(P<0 .01) .Conclusion EGFR mutation is closely related to the occurrence of lung ade‐nocarcinoma ,its high expressions in the women ,non smoking people have important clinical significance .HER‐2 and VEGF could promote the lung adenocarcinoma′s occurrence ,development and transfer .They could be used to evaluate the patients′prognosis ,and provide new molecular targeted therapy .

OBJECTIVE To investigate whether the KCNN4 gene and KPTN gene contribute to a Chinese non-syndromic hearing loss pedigree linked to DFNA4 with positional candidate approach. METHODS The complete coding region of the two genes were amplified with polymerase chain reaction (PCR), and bidirectional sequencing of the PCR products was subsequently applied in the 36 family members to identify the possible mutations or polymorphisms in the candidate genes. RESULTS Sequence analysis of coding regions and splice sites of the two candidate genes in 36 members including 12 hearing-impaired individuals in family Z002 failed to demonstrate any deafness-causing mutations of KCNN4 gene. There was one heterozygous mutation identified in exon10 coding sequence (942C/T) of KPTN gene, which did not result in amino acid change (P302P) as a repoerted synonymous SNP site (rs2293424). This SNP site did not cosegregate with the phenotype of family Z002. CONCLUSION Our study excluded the two candidates, KCNN4 and KPTN , as the causative genes involved in this Chinese DFNA4 pedigree.

Objective To establish a post?treatment prognostic score model for newly diagnosed metastatic nasopharyngeal carcinoma, and to investigate the feasibility of stratified therapy. Methods A total of 263 eligible patients with newly diagnosed metastatic nasopharyngeal carcinoma from 2002 to 2010 were enrolled as subjects. The primary tumor was treated with conventional radiotherapy, three?dimensional conformal radiotherapy, or intensity?modulated radiotherapy, and radiation areas included nasopharyngeal tumor and cervical lymphatic drainage region. The metastatic bone tumor was mainly treated with conventional external radiotherapy, while the metastatic liver or lung tumor was mainly treated with surgical resection, radiotherapy, or radiofrequency ablation. The first?line therapy for most of patients was cisplatin?based combination chemotherapy. Factors including the general characteristics, tumor status, and therapy for patients were involved in multivariate analysis, and a prognostic model was established based on the n value (HR=en ) of the prognostic factors. Results The factors influencing the overall survival (OS) in patients were a Karnofsky performance score (KPS) not higher than 70(P= 0?? 00), multiple organ metastases (P=0?? 00), combination with liver metastasis (P= 0?? 00), a number of metastases not less than 2(P= 0?? 00), a level of lactate dehydrogenase (LDH) higher than 245 IU/ L (P= 0?? 00), a number of chemotherapy cycles ranging between 1 and 3( P= 0?? 00), a poor response for metastatic tumor ( stable disease or progressive disease)(P= 0?? 00), and primary tumor not treated with radiotherapy (P= 0?? 01). Based on the prognostic score, patients were divided into low?risk group (0?1?? 5 points), intermediate?risk group (2?? 0?6?? 5 points), and high?risk group (≥7?? 0 points), and the 5?year OS rates in the three groups were 59?? 0%, 25?? 1%, and 0%, respectively. Conclusions The prognostic score model based on the KPS, serum level of LDH, multiple organ metastases, combination with liver metastasis, and number of metastases can effectively predict the survival in patients. Active treatment including at least 4 chemotherapy cycles and radiotherapy for primary tumor can prolong the survival time of patients in the low?and intermediate?risk groups. However, patients in the high?risk group were mainly treated with palliative radiotherapy due to no improvement in the survival by radiotherapy for primary tumor.

Objective To appraise the analytical capability of flow cytometric bead array for lung cancer markers through the tests of limit of detection,relative standard deviation,specificity,methods comparation and linearity rang.Methods The limit of detection,relative standard deviation,specificity and linearity rang in detection of Carcinoembryonic antigen (CEA),cytokeratin 19 (Cyfra21-1) and neuron specific enolase (NSE) in serum were evaluated by flow cytometer.Western blotting method was ultilized to validate the specificity of antibody-antigen recognization.The interference of hemoglobin,three acyl glycerol and bilirubin on the detection of CEA,Cyfra21-1 and NSE was tested.Compared to electrochemiluminescence immunoassay,the relative error for flow cytometric bead array was assessed.Results Flow cytometric bead array demonstrated that the limit of detection was 1.71 pg/mL for CEA,3.97 pg/mL for cyfra21-1,and 2.27 pg/mL for NSE.The relative standard deviation for intra-assay and inter-assay were below 10％ and 15％,respectively.The pair of antibodies can defferentially recognize antigens.The measurement for CEACAM6,CK18,NSE appeared that there was no significant cross-talking reaction.Three acyl glycerol and bilirubin did not significantly interfere with the detection for serum samples.Hemoglobin of 500 ng/mL can significantly interfere with the detection of Cyfra21-1 (P ＜ 0.05) and NSE (P ＜ 0.05).The correlation coefficient between flow cytometric array and electrochemiluminescence immunoassay was 0.984 2 for serum CEA,0.962 2 for serum cyfra 21-1 and 0.982 0 for serum NSE.The linearity ranged from 355.76 pg/mL to 367.74 ng/mL for CEA,from 87.89 pg/mL to 107.8 ng/mL for cyfra21-1,and from 90.12 pg/mL to 86.07 ng/mL for NSE.Conclusion Flow cytometric array for lung cancer markers may be of use in clinical detection.

Objective To compare the efficacy and safety of the treatment of panic disorder by electro-acupuncture(EA) and paroxetine.Methods 59 patients were randomly divided into paroxetine group (30 cases) and EA group (29 cases), the therapeutic course was 4 weeks.SAS, HAMA, CGI-EI, BI scale were given to evaluate the efficacy and adverse reactions at 1,2,4 weekend before treatment and after treatment .Results EA group total effective rate was 86 .66%, the paroxetine group total effective rate was 82.76%, the two groups total efficacy difference was not statistically significant;efficacy index and onset time between the two groups had significant differences .Conclusion The overall curative effects were similar in patients of the two groups , but onset short electro-acupuncture , the curative effect was high and adverse reactions were fewer .

Objective: To investigate the prevalence and related factors of obesity and central obesity among 35-75 year-old population in Jiangsu Province. Methods: During 2015-2017,83 530 eligible subjects aged 35-75 years from six study sites of Jiangsu Province were interviewed and examined. The data of demography,lifestyles,disease history,height,weight and waistline were collected. Logistic regression analysis was conducted for the influencing factors for obesity and central obesity. Results: A total of 83 393 residents completed the study,with a response rate of 99.84%. The prevalence of overweight,obesity and central obesity was 43.35%（standardized rate：35.90%）,20.02%（19.48%）and 59.93%（57.03%）. The results of multivariate logistic regression analysis showed that females（OR=0.822,95%CI：0.786-0.859;OR=0.900,95%CI：0.851-0.952;OR=1.130,95%CI：1.083-1.179）,45-75 years old（OR：1.120-1.731,95%CI：1.102-1.881）,graduating from high school or above（OR：0.767-0.902,95%CI：0.721-0.943）,living in urban areas（OR：1.530-2.077,95%CI：1.284-3.007）,smoking（OR：0.724-0.855,95%CI：0.678-0.898）,drinking （OR：1.125-1.179,95%CI：1.076-1.235）,hypertension（OR：1.884-3.461,95%CI：1.821-3.613）,diabetes（OR：1.363-1.758,95%CI：1.305-1.851）, dyslipidemia（OR：1.478-1.870,95%CI：1.429-1.851）were associated with overweight,obesity and central obesity. Conclusion The standardized prevalence rates of overweight,obesity and central obesity among 35-75 year-old population in Jiangsu Province are 35.90%,19.48% and 57.03%,respectively. Gender,age,education,residence,smoking,drinking,hypertension,diabetes and dyslipidemia are related factors.

Objective To discuss the expressions of VEGF ,EGFR and Smad4 in breast cancer tissue and their relationship with lymphatic metastasis .Methods 84 patients with breast cancer from June 2014 to June 2016 in our hospital were selected ,immuno-histochemical method was used to detect the expressions of VEGF ,EGFR and Smad4 ,and their relationship with lymphatic metas-tasis was analyzed .Results The positive expression rates of VEGF and EGFR were 22 .62% and 26 .19% respectively in breast cancer tissue ,which were notably higher than those in para-carcinoma tissue(22 .62% and 26 .19% respectively) ,and differences were statistically significant (P<0 .05) .Positive expression rate of Smad4 was 35 .71% in breast cancer tissue ,which was higher than that in para-carcinoma tissue(77 .38% ) ,and the difference was statistically significant (P< 0 .05) .The positive expression rates of EGFR and VEGF were 72 .92% and 70 .83% in Ⅲ + Ⅳ phase ,which were higher than those in Ⅰ + Ⅱ phase(50 .00% and 44 .44% ,respectively) ,differences were statistically significant(P<0 .05) .The positive expression of Smad2 was 25 .00% in Ⅲ +Ⅳphase ,which was lower than that in control group (50 .00% ) ,and the difference was statistically significant (P<0 .05) .The pos-itive expression rates of EGFR and VEGF were 77 .27% and 75 .00% in patients with lymphatic metastasis ,which were higher than those in patients without lymphatic metastasis (47 .50% and 42 .50% ) ,and differences were statistically significant (P< 0 .05) . The positive expression of Smad4 was 22 .73% in patients with lymphatic metastasis ,which was lower than that in patients without lymphatic metastasis (50 .00% ) ,and the difference was statistically significant (P<0 .05) .Pearson analysis showed that the posi-tive expression rates of EGFR and VEGF were positively associated with lymphatic metastasis (r1 =0 .382 ,r2 =0 .425 ,P<0 .05) , and the positive expression rate of Smad2 was negatively associated with lymphatic metastasis (r3 = -0 .468 ,P<0 .05) .Conclusion VEGF ,EGFR and Smad4 play an important role in the occurrence and development of breast cancer .The positive expression rates of EGFR and VEGF were positively associated with lymphatic metastasis ,and the positive expression rate of Smad2 was negatively associated with lymphatic metastasis ,which could have a guiding significance for prognosis of breast cancer .

OBJECTIVE:To provide reference for rational use of Clindamycin hydrochloride injection. METHODS:The utilization of Clindamycin hydrochloride injection in orthopedic inpatients of a third grade class A general hospital dur-ing 2013-2015 was analyzed and investigated retrospectively. The rationality evaluation standard was formulated to evaluate the rationality of drug use in those patients. RESULTS:A total of 189 orthopedic inpatients received Clindamycin hydro-chloride injection,and there were 152 cases of irrational drug use among which there were 16 cases of irrational therapeu-tic drug use and 136 cases of irrational prophylactic drug use. Irrational drug use mainly included irrational usage and dos-age(86.18%),irrational drug selection(44.74%)and irrational drug replacement(15.79%). Two patients suffered from ADE,i.e. rash and nausea. After drug withdrawal and symptomatic treatment,the symptoms were improved,but irrational drug use was found in one case. CONCLUSIONS:The utilization of Clindamycin hydrochloride injection is irrational in or-thopedic department. It is necessary to further standardize medication behavior and guarantee the safety and effectiveness of drug use.