Objective To investigate the factors associated with hyponatremia after pituitary adenoma surgery and its prognosis.Methods Clinical data of 120 pituitary adenoma patients treated in our hospital form Jan.2008 to Dec.2010 were retrospectively collected.The incidence of hyponatremia after surgery,clinicopathology and related treatment were analyzed.Results In the 120 patients,28 (23.3％) occurred hyponatremia.The blood natrium concentration recovered to normal in 7 patients within 3 days,and in 21 patients within 4 -7 days.Hyponatremia was associated with age,size of adenoma,type and diabetes insipidus early after surgery(x2 =12.6,12.4,5.38 and 6.51,Ps ＜0.05).Conclusion Hyponatremia after pituitary adenoma surgery is frequent in patients with giant pituitary adenoma,history of diabetes insipidus and older than 50 yrs.Monitoring blood electrolyte and treatment with sodium in 1 - 2 weeks after surgery would be helpful to prevent potential severe compilations.

Different diagnostic criteria are existed nowadays in grading the dysplasia of gastric mucosa in clinical practice. Novel endoscopic techniques and molecular markers could facilitate the pathologic grading of dysplasia. As to the treatment strategy,it is debatable whether to choose endoscopic dissection or conservative follow-up. Here,we reviewed the diagnostic grading and therapeutic options with regard to the dysplasia of gastric mucosa.

Endosonography ; Esophageal Neoplasms ; diagnostic imaging ; radiotherapy ; Humans ; Image Processing, Computer-Assisted ; Lymph Nodes ; diagnostic imaging ; pathology ; Positron-Emission Tomography ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; Tomography, X-Ray Computed ; Tumor Burden

Animals ; Cardiovascular Diseases ; etiology ; metabolism ; Humans ; Inflammation ; metabolism ; Periodontitis ; complications ; metabolism ; microbiology ; Platelet Aggregation ; physiology ; Porphyromonas gingivalis ; pathogenicity ; RNA, Messenger ; metabolism ; Receptor, PAR-1 ; metabolism ; Receptor, PAR-2 ; genetics ; metabolism ; Receptors, Proteinase-Activated ; metabolism ; Receptors, Thrombin ; metabolism

Objective To study the CT features and clinical value of cerebral ischemia infarction. Methods the CT feature of 106 diabetes ischemia infarction were analyzed. Results The patients with is-chemia brain white matter change (35 cases),small area cerebral ischemia infarction (85 cases),great area cerebral ischemia infarction ( 12 cases ),cerebral hemorrhage (6 cases). Conclusions Cerebral ischemia infarction of diabetes mellitus mainly as small area multiple cerebral ischemia infarction,ischemia cerebral white matter lesion located at the area of base ganglion thalamencephalon and cerebellum,termly CT cerebral examination can diagnosis and instruct treatment to the complication of cerebral ischemia apoplexy of type 2 diabetes mellitus.

Objective To clarify the mechanism of lipoprotein (a) ［Lp (a)］ metabolic disorder in patients receiving maintenance hemodialysis (MHD), and to offer theoretical basis for seeking for modus operandi of disorder control.Methods The apolipoprotein (a)［apo(a)］ isoforms were identified by high-resolution SDS-agarose gel electrophoretic method followed by immunobloting in 61 patients receiving maintenance hemodialysis (MHD group), 51 patients with end-stage renal disease (ESRD group) and 62 healthy controls (healthy control group). The influential factors for elevated serum level of lipoprotein (a) in MHD group were analyzed by applying statistical method.Results No statistical difference of Lp (a) median level was found between MHD group and ESRD group in LWM isoforms, but their level was significantly higher than that of healthy control group. In MHD group, the concentrations of serum creatine(Crea),cystatin C(CysC) and C-reactive protein(CRP) were significantly higher (P<0.05), while the concentrations of albumin(Alb) and Hb were lower than those of healthy control group (P<0.05). The concentration of LDL-C had no significant difference between MHD group and healthy control group. Compared with those of ESRD group, the levels of Crea, CRP and CysC were not significantly increased (P<0.05) in MHD group. There was no difference in the level of Lp (a) between the MHD and the ESRD patients with LMW-apo (a) isoforms (P>0.05), but compared with healthy control group, the serum levels of Lp (a) in the two groups were remarkably increased (P<0.05). The level of Lp (a) with LMW-apo (a) were significantly correlated with Alb and CysC respectively (P<0.05). The level of Lp (a) with HMW-apo (a) of MHD patients were higher than that of ESRD patients (P<0.05). The patients in the two groups had higher levels of Lp (a) as compared with those of healthy control group. The positive correlation of Lp (a) level with CRP and CysC was observed in patients with HMW-apo (a) (P<0.01). As MHD group as concerned, Lp (a) level was associated with Alb and CysC (P<0.01); regression analysis showed that apo (a) isoforms, Alb and CysC were listed in the regression equation, and the determinate coefficient (r2) was 0.348, in which the respective r2 of apo (a) isoforms, Alb and CysC was 0.121, 0.178 and 0.049.Conclusion Multiple factors may contribute to the high level of Lp (a) in MHD patients. Moreover, Lp (a) with different isoforms of apo (a) had different influencing factors. The corresponding therapeutic measure should be taken according to apo (a) isoforms in order to acquire better therapeutic efficacy for MHD patients.

Objective To investigate the clinical characteristics and currently treatment status of intractable ulcerative colitis (IUC). Methods A retrospective analysis was conducted on the data of inflammatory bowel disease patients, who were hospitalized in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from January 1999 to December 2009. According to the reaction to glucosteroids (GCS) treatment, they were divided into GCS effective group and intractable group. The general data, lesion, clinical symptoms and laboratory findings of these two groups were compared.Further treatments and the results of intractable group were analyzed. Results Totally 234 UC patients were enrolled, of which 37.6％ (88/234) patients received GCS treatment, intractable group and effective group took up 23.9％ (21/88) and 76.1％ (67/88) respectively. There was no significant difference of lesion between two groups (P＞0.05). Compared with effective group, the proportion of intractable group was higher in moderately severe bellyache[38. 1 ％ (8/21) vs 13. 4％ (9/67), P＝0.012, OR＝3.97, 95％CI:1.29～12.23], anemia[61.9％(13/21) vs 32.8％(22/67), P＝0.018,OR＝3.32, 95％CI:1.20～9.20], thrombocytosis[57.1％(12/21) vs 29.9％(20/67), P＝0.023,OR＝3.13, 95％ CI: 1.14 ～8.61]and hypoalbuminemia[38.1 ％ (8/21) vs 11.9％ (8/67), P＝0.007, OR＝4.54, 95％CI: 1.44～ 14.32]. Some patients of intractable group could be remission through extending period of GCS treatment, adding the immunomodulators or biological agents and intestinal segment excision. Conclusion UC patients with moderately severe bellyache, anemia,thrombocytosis, hypoalbuminemia at the onset of disease, which may indicate relatively poor response to GCS treatment. Immunomodulators, biological agents and surgery are the further treatment for IUC patients.

ISO 15189 standard quality management system developed by the International Organi-zation for Standardization (ISO) embodies the international medical laboratory's latest quality management concept, and puts forward the quality improvement method of the standard. In this research, ISO 15189, as an important content in practice teaching for laboratory medicine, was designed according to the elements of this system. Students were requested to participate in every linkage of laboratory quality management by writing system document, taking part in quality activity, and practicing the key and difficult points of tech-nique in quality system in order not only to cultivate their basic idea of ISO 15189 standard, but also to make them familiar with the basic patterns of laboratory accreditation system and process, which could make them become the backbone of the laboratory quality management quickly in their vocational positions in the future.

OBJECTIVE To investigate the strategy of information system in antibiotics usage management. METHODS By inquisition,statistic and analytic methods the antibiotics usage information of the hospitalized patients was recorded with the information system,to realize the realtime monitoring and process management. RESULTS The usage rate of antibiotics decreased from 88.79% to 80.19% and the prophylactic usage rate of the third cephalosporin decreased from 72.34% to 11.25%.The rational usage rate increased from 57.89% to 80.18%. CONCLUSIONS The management method of antibiotics usage with information system achieves obvious effect.

Objective To observe the clinical effect ofHuangkui capsule combined with benzbromarone on the treatment of the patients with chronic uric acid nephropathy (CUAN).Methods A total of 60 patients were recruited and divided into the treatment group and the control group by using the random number table method, each group 30 patients. Two groups were treated with conventional treatment, such as low purine, low protein diet, quit smoking and drinking extra water. The control group was added with oral benzbromarone, and the treatment group was added with oralHuangkui capsule. All the treatments last 8 weeks. Theblood uric acid (BUA), serum creatinine (SCr), blood urea nitrogen (BUN), cystatin C (Cys-C), SOD, 24-hour urinary protein quantity and Urinary sediment red blood cell count were detected by the automatic biochemical analyser.The clinical effect was evaluated by the Rheumatoid arthritis (RA) quality of life questionnaire.Results Compared with the control group, the total effective rate in the treatment group was 86.64% (26/30), which was significantly higher than that of 63.33% (19/30) in the control group (χ2=7.264, P=0.001). After treatment, the BUA (273.52 ± 110.37μmol/Lvs. 331.28 ± 126.54μmol/L,Z=-2.543), BUN (6.24 ± 1.23 mol/Lvs. 8.16 ± 2.35 mol/L,Z=-2.680), SCr (90.37 ± 20.16μmol/Lvs. 110.38 ± 16.72μmol/L,Z=-2.534), Cys C (0.86 ± 0.51 vs. 1.03 ± 0.10,Z=-2.372) in the treatment group were lower than those of the control group (P<0.01); SOD (156.37 ± 32.04μmol/Lvs. 43.36 ± 31.52μmol/L,Z=-2.041) in the treatment group was higher than that in the control group (P<0.01); the 24 hours urinary protein (439.86 ± 250.41 mg/24hvs.897.69 ± 213.37 mg/24h,Z=-2.853), urine sediment RBC counts (50.31 ± 14.06 points/μlvs.213.47 ± 38.46 points/μl, Z=-2.106) in the treatment group were lower than those in the control group (P<0.01); the physiological function(43.14 ± 2.06 pointsvs.36.48 ± 3.21 points,Z=10.362), the psychological function (40.76 ± 3.28 points vs. 16.54 ± 3.71 points,Z=9.547), social function (40.74 ± 3.58 points vs. 33.04 ± 5.48 points,Z=6.034), healthy self-awareness (24.57 ± 1.97 points vs. 22.63 ± 3.43 points,Z=4.236) and total score (127.38 ± 6.43 points vs. 107.69 ± 13.57 points,Z=6.754) in the treatment group were higher than those in the control group (P<0.01) . Conclusions TheHuangkui capsule combined with benzbromarone could reduce CUAN patient's blood uric acid levels, protect renal function, and improve the quality of life.