Objective To investigate the diagnostic value of serum miR-21 andCA199 for pancreatic cancer,and aim to provide a potential diagnostic method for the diagnosis of pancreatic cancer in clinical practice.Methods Detect the levels of CA199 and the relative expression of miR-21 in 134 pancreatic cancer patients,97 benign pancreatic disease patients and 106 healthy subjects from January 2014 to December 2015 in Clinical Laboratory of 263 Clinical Department of Army General Hospital,Evaluate the diagnostic value of single and combined detection of CA199 for pancreatic cancer.The diagnostic values were evaluated by receiver operating characteristic curve,sensitivity and specificity.The area under the receiver operating characteristic curve was compared by the z-score test.Results Compared with healthy control group,CA199 and miR-21 in benign pancreatic disease group and pancreatic cancer group showed significantly increased.Compared with benign pancreatic disease group,CA199 and miR-21 alsoshowed significantly increased in pancreatic cancer group.For discriminating the healthy control group and pancreatic cancer group,the sensitivity and specificity were 77.61％and 69.81％respectively when combination CA199 and miR-21.The AUC of combination CA199 and miR-21 was0.85,it showed significantly higher when compared with CA199 and miR-21 alone(P=0.021,P=0.036).For discriminating the benign pancreatic disease group and pancreatic cancer group,the sensitivity and specificity were 69.40％and 65.98％respectively when combination CA199 and miR-21.The AUC of combination CA199 and miR-21 was 0.78,it showed significantly higher when compared with CA199 and miR-21 alone(P=0.017,P=0.023).Conclusions miR-21 showed certain diagnostic value for pancreatic cancer.Combined with CA199,miR-21 may provide a potential assistant diagnostic method for the diagnosis of pancreatic cancer.

Objective: To study the mechanism of electromyographic (EMG) biofeedback. Methods: The EMG and electroencephalographic (EEG) signals were recorded dynamically during the course of EMG biofeedback. Changes of EMG amplitude and frequency during EMG biofeedback were assessed with linear analysis. We also applied the nonlinear analysis, approximate entropy (ApEn) of EMG signals and Cross Approximate entropy (Cross-ApEn) between EMG and EEG signals, to assess regularities in EMG and correlation between EMG and EEG. Results: With the processing of EMG biofeedback, the maximum, minimum and mean amplitude of EMG signals decreased significantly (F=3.85~25.59,P

Objective To discuss the application value of the multi-slice spiral CT in diagnosing breast cancer. Methods The images of scanning, enhancing and reconstruction were analyzed in 29 cases of breast cancer proved by clinical pathology. Results All the 29 cases were the type of mass. 25 cases of them located in outer and upper quadrant of the galactophore. The shapes of the tumor in 22 cases were irregular , burrs can be seen in 9 cases, the skin in 4 cases changed, the nipples in 2 cases sunk, the tissue around the tumor was invaded in 5 cases; The CT value of the tumor rised greatly after enhancement, the ranges of value was from 18 to 83 HU. Axilla lumph nodes were detected in 16 cases, we can find the lumph node in mediastinum and lung metastasis in 3 cases; The tumor and the tissue around it can be shown well in multi-orientations through image reconstruction. Conclusion The multi-slice spiral CT has the evident application value in qualitative diagnosing breast cancer.

Objective To make an epidemiological investigation on TORCH infection in children in Pu′er city of Yunnan prov‐ince ,in order to provide references for the prevention and treatment of TORCH infection in children .Methods A total of 1 194 children treated at this hospital from January to December 2014 were selected and divided into five age groups .Serum TORCH spe‐cific IgM and IgG antibodies were detected by using enzyme‐linked immunosorbent assay(ELISA) and the positive rate of TORCH specific antibody and TORCH infection rate were comparatively analysed .Results The positive rate of TORCH specific IgM anti‐body was significantly lower than that of IgG .The range of positive rate of IgM was 0 .00% -3 .10% ,and that of IgG was 10 .13% -82 .24% .The total infection rate of TORCH was 96 .98% .There were no significant differences in the infection rate of single item of TORCH or the total TORCH infection rate among the five different age groups(P>0 .05) .The distribution of infec‐tion rate of single item of TORCH among the five age groups was statistically significantly different(P<0 .05) .There was no sig‐nificant difference in the infection rate of TORCH or the distribution of infection rate of single item of TORCH among different sea‐sons(P>0 .05) .Conclusion Children with TORCH infection in this area mainly are infected by CMV ,followed with RV and HSV infections ,while TOX infection is uncommon .There are no obvious differences in different seasons and children in different age groups .

Objective To analyze the results of children′s respiratory tract infection pathogens IgM antibody nine‐combined de‐tection in Pu′er and grasp the epidemiological characteristics of respiratory tract infection of local children for providing reference for clinical diagnosis and treatment .Methods 1 327 cases of children′s blood sample with respiratory tract infection were randomly sampled from in Pu′er People′s Hospital in 2014 .All the samples were tested with nine respiratory tract infection pathogens IgM antibody detection reagent kit(indirect immunofluorescence) ,and the test results were adopted for statistical analysis .Results There were 446 cases positive for IgM antibody in 1 327 cases of respiratory tract infection children ,the total positive rate was 33 .6% .The Positive rate of mycoplasma pneumonia(MP) was the highest ,for 23 .6% .The second was influenza B virus(INFB) , for 18 .5% .The eosinophilic lung legionella type 1(LP) ,adenovirus(ADV) ,respiratory syncytial virus(RSV) ,influenza A(INFA) and parainfluenza virus(HPIVs) were all much lower :respectively for 0 .4% ,1 .1% ,1 .0% ,1 .1% and 1 .0% .It was showed that no positive results were found in Q fever rickettsia(CB) and chlamydia pneumonia(CP) .There was significant difference of the positive rate among 9 kinds of pathogens(P<0 .05) .There was significant difference of the monthly positive rate among the main six patho‐gens(P<0 .05) .There was significant difference of the positive rate in the different age groups(P<0 .05) .Conclusion The respir‐atory tract infection pathogens of children in Pu′er are mainly mycoplasma pneumoniae and influenza B virus .The epidemiological distribution of the pathogens is related to the age and season ,the clinician should reasonably diagnose and treat according to the test results for children .

Objective To explore the efficacy of dermatophagoides farinae drops for treating allergic rhinitis in children and its influence on serum IL‐4 and IL‐35 levels .Methods A total of 80 children with mite sensitized allergic rhinitis in the Central Hospital of Nanyang city from January 2012 to October 2013 were selected as the research subjects and randomly divided into the control group and the observation group according to random number table method ,40 cases in each group .The control group was given the symptomatic treatment ,while the observation group was given sublingual dermatophagoides farinae drops .The treatment lasted for 18 months .The efficacy ,symptom score and eosinophil count value (Eos) were observed .ELISA was used to detect ser‐um IL‐4 ,IL‐35 levels .Results The total effective rate after treatment in the observation group was 97 .50% ,which was higher than 92 .50% in the control group ,but without statistically significant difference between them(χ2 =1 .052 6 ,P=0 .305) .After treat‐ment ,the symptom scores ,medication scores and Eos count had statistical differences in the two groups were significantly lower than before(P<0 .05) ,but which had statistical differences between the two groups after treatment(P<0 .05);serum IL‐4 level af‐ter treatment in the two groups were significantly lower than before(P<0 .05) ,while the IL‐35 level was significantly higher than before(P<0 .05) ,the serum IL‐4 and IL‐35 levels after treatment had statistically significant differences between the two groups (P<0 .05) .The incidence rate of adverse reactions showed no statistically significant difference between the two groups (χ2 =0 .213 3 ,P=0 .644) .Conclusion Sublingual specific immunotherapy of dermatophagoides farinae drops can effectively improve the symptoms of mite sensitized allergic rhinitis in children ,reduces proinflammatory cytokine IL‐4 level and increases suppressing in‐flammatory cytokine IL‐35 level .

Objective:To explore the reason why the CT manifestation of the patients with chronic nasosinusitis is negative.Method:To analyze the clinical and CT manifestation of the patients with chronic sinusitis having a negative CT manifestation.Result:Pathological changes were found in all 8 patients during the course of endoscopic sinus surgery, such as pus storing in the sinus cavity, mucous swelling polypoidly, small polyps formation and so on. Conclusion:The reasons that the patients with chronic sinusitis having a negative CT manifestation are, ①CT scan can only give a static one-off image, ② partial volume effect,③ maybe result from the location of CT scan and the resolving power of tomograph,④ maybe attribute to the pathological classify of chronic sinusitis.

Objective To evaluate the sensitivity and specificity of Rome Ⅲ criteria in diagnosis of functional dyspepsia (FD) and assess its value in differentiate FD from other organic diseases in upper gastrointestinal tract. Methods Four thousand nine hundred and sixty-two patients, who underwent gastroscopy from July to August 2006 and March to April 2007, were consecutively enrolled and interviewed face to face with a standard questionnaire. The patients who were diagnosed as FD were according to Rome Ⅲ criteria, and those who were diagnosed as upper gastrointestinal diseases, such as chronic erosive gastritis (CEG), gastric ulcer (GU), duodenal ulcer (DU) and gastric carcinoma (GC), were done by gastroscopy and pathology. The differences of clinical characteristics among these diseases were analyzed. Results The FD patients accounted for 7.58% (376/4962) with female in predominant (P = 0.000). The patient with CEG, GU, DU or GC accounted for 29.99% (1488/4962), 1.89% (94/4962),4.25% (211/4962) or 4.57% (227/4962), respectively, all with male in predominant (P<0.05). Further analysis indicated that the age of onset between patients with FD and DU was no difference, but was younger than those with other three diseases (P<0.05). The incidence of early satiation and postprandial in FD patients were higher than those in other patients (P<0.05). The incidence of belching, nausea and vomiting showed no difference among these patients(P>0.05). According to Rome Ⅲ criteria, the symptoms of epigastric pain, early satiation, postprandial fullness and epigastric burning had higher sensitivity and specificity (except epigastric burning)in diagnosing FD (P<0.05), with highest Youden index in epigastric pain (0.42) and postprandial fullness (0.46). Conclusion Rome Ⅲ criteria has high specificity and sensitivity in diagnosing FD, and also has an important value in differentiate FD from other organic diseases.

OBJECTIVETo study the classification and individualized treatment of the terminal phalanx of thumb duplication.

METHODSFrom Apr. 2003 to Dec. 2012, 76 patients with 77 involved thumbs duplication at the level which is distal to the interphalangeal joint were retrospectively studied. Based on the morphology (the nail width and the thumb circumference) and the deviation of the thumb, we classified the terminal phalanx of thumb duplication into 5 types as Type A (no bony connection called floating thumb), Type B(asymmetry and no deviation), Type C(asymmetry and deviation), Type D (symmetry and no deviation) and Type E(symmetry and deviation). Different surgical procedures were selected according to different types. Simple excision of the smaller thumb was adopted for Type A case. Removement of the smaller thumb (usually the radial) and of the collateral ligament of the interphalangeal joint were selected for Type B. Removement of the smaller thumb (usually the radial) and reconstruction of the collateral ligament of the interphalangeal joint, as well as corrective osteotomies at the neck of the proximal phalanx were performed for Type C. The modified Bilhaut-Cloquet procedure with reconstruction of the collateral ligament of the interphalangeal joint were adopted in Type D. The classical Bilhaut-Cloquet procedure, or the modified Bilhaut-Cloquet procedure with reconstruction of the collateral ligament of the interphalangeal joint and corrective osteotomies at the neck of the proximal phalanx were performed in Type E. The results were assessed by an evaluation form for thumb duplication by the Japanese Society for Surgery of the Hand.

RESULTSAccording to our new classification standard, there were 3 cases with Type A duplicated thumbs, 36 with Type B, 13 with Type C, 15 with Type D, 10 with Type E. All the 76 patients underwent the individualized surgical treatment. The patients were followed up for 6-60 months. According to the evaluation form, excellent results were achieved in 66 thumbs, good in 9 thumbs and fair in 2 thumbs.

CONCLUSIONSThe new classification could comprehensively describe the clinical features of the terminal phalanx of congenital thumb duplication. Individualized therapy, including basic and repeated surgical procedure could be adopted for each type with satisfactory results.

Child ; Collateral Ligaments ; surgery ; Finger Phalanges ; surgery ; Humans ; Orthopedic Procedures ; methods ; Osteotomy ; methods ; Polydactyly ; classification ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Thumb ; abnormalities

Objective To investigate the dementia caregivers' awareness of dementia diagnosis for patients aged≥80 years in veterans community in Beijing.Methods Patients aged 80 years and over who were diagnosed as dementia were selected from Dec.2009 to Jul.2011 in the veterans community in Beijing.A face-to-face interview and questionnaire survey were conducted in dementia caregivers individually,including basic social demographic data (gender,age,educational background),awareness rate of dementia,treatment and drug use situation and their attitude to dementia patients.Results A total of 118 caregivers were investigated individually.The caregivers in this study were mainly the spouse of the patients,and most of them were elderly people.46.6％ (55/118) of caregivers were the spouse of the patients,and 52.5％ (62/118) of caregivers were 65 years old and over.The caregivers' awareness rate of dementia was 32.3％ (38/118) when patients were diagnosed as dementia.There was no correlations of gender,age and educational background with the awareness rate of dementia diagnosis (all P＞0.05).50％ of dementia patients received the dementia treatment,and only 17.8％ (21/118) of patients got the first line drug treatment for dementia (acetylcholinesterase inhibitors and / or memantine).98.3 ％ (116 / 118) of caregivers agreed that the dementia patients should be treated kindly.Conclusions The dementia caregivers are mainly patients' spouse in veterans community and most of them are the elderly.The awareness rate of dementia diagnosis is low among the caregivers.Most patients do not take the formal treatment.The social support for the dementia caregivers should be strengthened.