Objective To provide the evidence for the clinical prevention and early treatment for the complication by testing microcirculation of the middle fingertip in renal failure patients with hemodialysis.Methods High-frequency ultrasounds combined with E-flow technique were applied to detect the Doppler velocitg index of middle fingertip's nail bed arteriole and ventral arteriole in 35 renal failure patients with hemodialysis.Peak systolic velocity(PSV),end-diastolic velocity(EDV)and vascular resistance index(RI)were separately measured,and comparison were made with healthy adults and renal failure patients without hemodialysis(sex and age matched).Results Compared with normal control,PSV and EDV of middle fingertip's nail bed arteriole and ventral arteriole were degraded statistically(P＜0.05),while RI was increased statistically(P＜0.05)in renal failure patients with and without hemodialysis.Compared with renal failure patients without hemodialysis,PSV and EDV were degraded(P＜0.05)and RI was increased(P＜0.05)in renal failure patients with hemodialysis.Conclusions High-frequency ultrasound combined with E-flow imaging technique can evaluate the microvascular peripheral resistance in renal failure patients with hemodialysis.

Objective To investigate epidermal growth factor receptor(EGFR)expression and tumor residual to the prognostic value in patients with nasopharyngeal cancer(NPC).Methods 200 patients with NPC were examined for EGFR expression by immunohistochemistry analysis,neck cancer and nasopharyngeal residual.Results In 200 cases with NPC,expression of EGFR of positive and negative were 160 cases(80.0%) and 40 cases (20.0%);the rate of overall survival(OS),disease-free survival (DFS),loeoregional relapse-free survival (LRFS) and distant metastasis-free survival(DMFS)in patients with positive EGFR were 72.3%,63.6%,72.2%,63.8% and negative EGFR were 90.0%,90.0%,90.0%,90.0%,respectively in 3-year(X2=3.95,X2=4.12,X2=3.98,X2=4.15,P＜0.05),the rate of local recurrence,distant metastasis rate in residual were 26.6%,32.5% which is significantly higher than 8.1%,18.1% in without residual(X2=4.75,X2=4.94,P＜0.05);the hish expression of EGFR with DFS,OS were significantly correlated(r=6.457,P＜0.05).Conclusion The overexpress of EGFR had the tendency of poor prognosis.tumor residual after radiotherpy can be a prognostic indicator for patients with NPC.

AIM　To find new anticancer drug based on the structure of podophyllotoxin. METHODS AND RESULTS　4-Deoxy-4β-arylmethylenesulfonylamido-4′-demethylpodophyllotoxins were (1-15) synthesized and their antitumour activities against KB cells and L1210 leukemia cells were tested. CONCLUSION　These compounds are new compounds. Among them, compounds 2, 3, 8, 9, 11 and 12 showed antitumour activities. When halides exist on the aryl ring of substituted sulfonyl group, the corresponding compound has relatively higher activities. The stereo factor is important for the activities.

Objective:To investigate the effect of vitamin E, selenium and quercetin on the expression of zf-9 mRNA of hepatic stellate cells (HSC) during early acute liver injury in rats. Methods:90 healthy SD rats were randomly divided into four groups: normal control, pathological control, VE 20 mg/(kg bw﹒d) + Se 16 ?g/(kgbw﹒d) supplement, and quercetin 50 mg/(kg bw﹒d) supplement through intragastric way for 15 d respectively. The normal control group was injected with normal saline, the others were given intraperitonal CCl4 once to induce acute liver injury model. The serum levels of MDA, SOD, ALT and AST were determined at 3 h, 6 h, 12 h and 24 h after CCl4 injection respectively. The pronase-collagenase perfusion of liver was used to isolate HSC, and the expression of zf-9 mRNA was examined by RT-PCR. Results: Serum levels of MDA were lower in VE+Se supplement group and quercetin supplement group than pathological group. Supplementation with VE+Se and quercetin could decrease the level of ALT and AST and down-regulate the expression of zf-9 mRNA. Conclusion:Dietary supplementation of VE,Se and quercetin could effectively down-regulate the expression of zf-9 mRNA in HSC during early acute liver injury in rats.

Objective To investigate the pathogens and their drug resistance of neonatal skin infection in Maternal-Neonatal Unit to provide evidence for rational selection of antibiotics.Methods Secretions of skin lesions from newborns with skin infections delivered in Maternal-Neonatal Unit,Department of Obstetrics of Beijing Daxing People's Hospital from Jan.2009 to Dec.2010 were collected,cultured and identified for bacterial serotype.Antibiotic resistances of pathogens were determined.Enumeration data was presented by frequency and rate.The difference between groups was compared with Chi-square test.Results Two hundred and six newborn skin infection cases were diagnosed,which accounted for 2.3％ of all newborns (n=9131) delivered in the hospital during the study period.Two types of skin infection were identified,impetigo (n=192,93.2％) and omphalitis (n=14,6.8％).Totally 154 pathogens were found,including 95 (61.7％) Gram-positive cocci and 59 (38.3 ％) Gram-negative bacilli.The major pathogens among Gram-positive cocci were Staphylococcus aureus (45/154, 29.2％), followed by Staphylococcus epidermidis and Staphylococcus haemolyticus.Staphylococcus was sensitive to Cefazolin,Amoxicillin/clavulanic acid and Piperacillin/tazobactam,while resistant to Penicillin,Ampicillin and Erythromycin.The major pathogens among Gram-negative bacilli were Enterobacter cloacae (19/154,12.3％),followed by Escherichia coli and Klebsiella pneumoniae.Drug resistance rate of Gram-negative bacilli was high in penicillin,aminoglycosides and cephalosporins,while they were sensitive to piperacillin/tazobactam,Ampicillin/sulbactam,carbapenems and Quinolones.Conclusions Gram-positive cocci are the main pathogens of neonatal skin infection in the Maternal-Neonatal Unit,and among which Staphylococcus aureus is the major pathogen.Multi-drug resistance is common in the identified pathogens.Attentions should be paid to use antibiotics reasonably according to drug sensitivity test.

Objective To evaluate the application value of three-dimensional power Doppler imaging(3D-PDI) in diagnosis of carotid artery stenosis in the elderly. Methods A total of 72 elderly patients with history of hypertension, coronary atheroselerosis, diabetes mellitus or hyperlipidemia were included in the study. The condition of carotid artery stenosis was examined by colour doppler flow imaging (CDFI), 3D-PDI in free-hand mode, and measured by digital subtraction angiography (DSA) as a golden standard in 24 hours. The sensitivity, specificity, positive and negative predictive values were calculated, and all the results were compared with CDFI. Results 3D-PDI directly showed the stereo image, including surface character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow. Seventy two patients had 85 stenosis of carotid arteries. There was no statistical difference in diameter stenosis rate between CDFI and 3D-PDI [(49.2±0.7)% vs. (52.3±0.3)%,P>0.05], and the area stenosis rate measured by 3D-PDI was significantly lower than by CDFI[(53.24±0.7)% vs. (59.3±0.4)%, P<0.01]. In the diagnosis of stenosis classification, the diagnostic sensitivities of light, mild and severe stenosis were significantly different between CDFI(88.9%,100.0%,100.0%) and 3D-PDI(100.0%,70.4%,58.1%) all(P<0.01). The 3D-PDI was better in diagnostic sensitivity of mild and severe stenosis, but specificity was not better than CDFI. Conclusions 3D-PDI is an easy, convenient method with no-wound and good reproducibility in the diagnosis of carotid artery stenosis. It is more accurate than CDFI and similar to DSA.

Objective To discuss the features,such as clinical symptoms,pathologic morphologies,immunohistochemical staining of minimal deviation adenocarcinoma and microglandular hyperplasia of the uterine cervix in order to improve the accuracy of pathological diagnosis.Methods s:Histopathologic characteristics of total hysterectomies in 2 cases of minimal deviation adenocarcinoma and 1 case of cervical microglandular hyperplasia based on the formalin-fixed,paralfin-embedded and hematoxylin-eosin stained tissue were analyzed retrospectively.Immunohistochemical staining was used to detect the expression of CEA,p53,PCNA,and Ki-67 in all 3 cases.Results The main clinical symptoms of minimal deviation adenocarcinoma were watery leucorrhea and enlargement of the cervix.The pathological findings of MDA included hyperplasia of the glands with cytological minimal atypia,invasion effects into the stroma could be observed in some glands and abortive glands with desmoplastic changes,or edema and inflammatory infiltration around the glands were also observed.The invasion presented in the deep part of the cervix as well.The patiant of MGH had a history of oval contraceptive use.Histological features of MGH included tightly packed glands in different sizes and shapes,presentation of inflammatory cells in stroma and glandular lumens,and focal epithelial cell pleomorphism and hyperchromatism but without mitosis.CEA was positive in all two MDA cases,but the tissue of MGH was negative for CEA.The expressions of the other four markers had no difference between MDA and MGH.Conclusions For patients with watery discharge and/or hypertrophy of cervix,the deep ( ＞ 5 mm ) biopsies should be performed.The immunohistochemical staining for CEA,p53,CA125 and ER has adjuvant diagnostic values.It is extremely important to recognize that MGH is an entirely benign lesion.

Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease ( CAD ) in the first-degree relatives or non-first-degree relatives of men with type 2 diabetes. Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for 5 years. The primary outcome was acute coronary syndrome suspected during subsequent 5 years, and the coronary angiography was conducted simultaneously. The severity of CAD was assessed by the coronary stenosis index ( CSI) and the number of coronary lesion vessels. Results In normal blood glucose group, serum uric acid was higher in the first-degree relatives of diabetics compared with non-first-degree relatives(P<0. 01), along with higher morbidity of CAD, CSI, and coronary lesion vessels (all P<0.01). Correlation analysis showed that CSI(r=0. 250, P=0. 041) and coronary lesion vessels(r=0. 252, P=0. 040) in non-diabetics group were associated with baseline levels of serum uric acid. Conclusion The elevation of serum uric acid was closely related to subsequent CAD, especially in first-degree relatives of male with type 2 diabetes, which could be used as an early indicator for CAD prediction.

Objective Based on the objective test (A type) results of the 2014 comprehensive clinical course graduation test of 3+2 assistant general practitioners training,this article analyzed the differences between different teaching units,so as to provide objective basis for improving the teaching level of each unit.Method We established a database with EXCEL 2000,and put each question's ID and points,and the score of each student into the computer,so we could get the difficulty coefficient,distinction degree and reliability of the test paper,and calculate the difficulty coefficient and difference of each question.Then we analyzed the difficulty coefficient,the difference and the reliability of the 122 students' testing results,and compared the accuracy to the same question of the 6 teaching units.Result The objective test's (A type) difficulty coefficient is 0.77,distinction degree is 0.19,and reliability is 0.99.The highest score of the 122 students is 47 points,and the lowest score is 28 points,the average score is (38.5 ± 3.9) points.In the 50 questions,3 questions' difficulty coefficient is less than 0.4,14 questions' difficulty coefficient is between 0.4-0.7,33 questions' difficulty coefficient is above 0.7,so the difficulty degree of the paper is relatively low.In the 50 questions,23 questions' distinction degree is less than 0.15,17 questions' distinction degree is between 0.15-0.30,10 questions' distinction degree is above 0.30,so the distinction degree of the paper is relatively high.In the 50 questions,20 questions' accuracy appears larger differences between each unit:9 questions' accuracy has decreased significantly among 1-2 units,4 questions' accuracy decreased significantly among 3 units,3 questions' accuracy decreased significantly among 4 units,only 1 unit has high accuracy among 2 questions,and 2 questions' accuracy decreased significantly among all units.These problems are related to the teachers' teaching ability,the difficulty in mastering the key points of the curriculum,the lack of the concept of the general practitioners training.Conclusion The design of the examination paper is basically in line with the study purpose and the objectives of the training course.This examination paper was highly reliable,and suitable for the professional theory and ability test.There are site differences between each unit,which can provide an objective basis for improving the teaching level of different teaching unit,and we will solve the problems in the form of collective preparation next step.

Objective To summarize the magnetic resonance imaging/ 1 H-magnetic resonance spectroscopy (MRI/1 H-MRS) features of tumor-like inflammatory demyelinating diseases (TIDD),and investigate the clinical value of MRI/1 H-MRS.Methods MRI features of 10 cases of TIDD in brain confirmed by pathology were retrospectively analyzed and compared with pathology.Results The lesions mainly located in the white matter with mild mass effect.MRI scan all showed low T1 high T2 signal,and 7 cases showed high signal,3 cases showed slightly high or mixed signals on DWI.Enhanced MRI showed 5 cases with significant enhancement withopen loop sign,4 cases with significant patchy or nodular enhancement,1 case with mild flakes or linear enhancement.Three cases showed expanded blood vessels and plumbed to the lateral wall inside the edge of the lesions.1H-MRS performance showed 4 cases all with significantly increased Lac and Lip; 3 cases with rised glutamate and glutamine complex β,γ-Glx peaks,reduced N-acetylaspartate acid (NAA),increased Cho to varying degrees.All pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis,hypertrophy and abnormal mitotic figure.Seven cases could be seen obesity glial cells.Conclusions TIDD had its salient MRI features:lesion had obvious edema and mild mass effect,MRI enhancement showed open loop sign and small veins expansed,on perfusion-weighted imaging it showed low perfusion.1H-MRS showed β,γ-Glx peaks,Lac and Lip peaks significantly increased,NAA slightly reduced,Cho mildly elevated.Comprehensively analyzing the MRI and 1H-MRS features,combined with clinical manifestations,contribute to the diagnosis of the disease.