Objective To investigate clinical significance of D-dimer and other easily-obtained laboratory parameters in rapid screening for acute aortic dissection ( AAD). Methods Data of general health, clinical symptoms, white blood cell (WBC) count, serum levels of C-reactive protein (CRP),cardiac troponin Ⅰ (cTn Ⅰ ) and D-dimer in patients with confirmed AAD and acute coronary syndrome (ACS) were retrospectively analyzed. Significance of varied parameters in clinical diagnosis for AAD was evaluated by logistic regression model and their diagnostic values were evaluated by receiver operating characteristics (ROC) curve. Results Serum level of D-dimer increased significantly in patients with type Ⅰ AAD, as compared with that in those with type Ⅱ and type Ⅲ (P = 0. 111 and 0. 002, respectively). D-dimer, WBC and CRP all were independent risk factors for type Ⅰ AAD by logistic regression model fitted,with the largest effect of D-dimer. Analysis by ROC curve with sensitivities and specificities of serum levels of D-dimer and CRP, and WBC count also showed the same results. Conclusions Determination of serum level of D-dimer had significantly diagnostic value for AAD, and can be sued as rapid screening for it if combined with determinations of WBC and CRP.

Objective To investigate the clinical features and treatment of mycoplasma pneumoniae infection complicated with allergic purpura.Methods 40 children with mycoplasma pneumoniae infection complicated with allergic purpura were selected.Clinical symptoms,disease treatment and outcome were analyzed retrospectively.Results 25 cases were abdominal type allergic purpura,9 cases were articulated joints allergic purpura,6 cases were kidney patients with allergic purpura.In addition,some patients showed upper or lower respiratory tract infections.All the patients received blood circulation improvement,anti-allergy and other conventional treatment,and on the basis of this,azithromycin,low-dose dexamethasone or gamma globulin was given.All 40 patients were cured,the average length of hospital stay was (18.6 ± 3.1) d.Conclusion Mycoplasma pneumoniae infection may trigger allergic purpura purpura-like rash,the clinical symptoms,some accompanied by lower respiratory infections,should give the conventional anti-mycoplasma pneumoniae infection treatment,and the treatment time should be sufficient to cure allergic purpura,shortening hospitalization time,has an important role in the prevention of recurrent disease.

Objective To Establish evaluation methods for the performance of flow cytometer .Methods Referring to the indus‐try standard YY/T0588‐2005 Flow Cytometry ,evaluating methods for the performance of BriCyte E6 flow cytometry was estab‐lished ,such as fluorescence sensitivity ,fluorescence linearity ,forward scatter sensitivity ,instrument resolution ,forward scatter/side scattering resolution ,DNA content linearity ,carry‐over rate ,accuracy of the cell surface marker ,reproducibility of the cell surface marker and instrument stability .Results The performance of BriCyte E6 met the requirements of industry standard .Conclusion The evaluation methods for the performance parameters could be reliable and could be used for the performance evaluation of flow cytometer .

Objective To investigate the diagnostic value of procalcitonin(PCT)as an early indicator for sepsis.Methods Serum levels of PCT and C-creative protein(CRP)and white blood cell (WBC)count were measured in 30 patients in critical condition hospitalized at an intensive care unit(ICU) with diagnosis of systemic inflammatory response syndrome(SIRS).They were divided into two groups, sepsis and non-sepsis,based on their clinical manifestations and results of lab tests.Blood specimen was collected from each patient for measurement of PCT,CRP and WBC count on the 1~(st),3~(rd)and 7~(th)day after hospitalization and bacteriological culture for blood and sputum,and chest X-ray was performed,as well. Acute physiology,age and chronic health evaluation(APACHE Ⅱ)was made on the 1~(st),3~(rd)and 7~(th)day after hospitalization to assess their ill condition.Their prognosis were judged on the 28~(th)day of the follow-up. Results Serum level of PCT increased significantly in the sepsis group(with the highest of 10.13 ng/ml), as compared with that in the non-sepsis group.Sensitivity,specificity and predictive value of a positive test for a cut-off value of serum level of PCT at 0.5 ng/ml were 97.0%,91.7% and 82.1%,respectively, which were all better than those of serum level of CRP and WBC count.Serum level of PCT in the patients was significantly associated with their prognosis,and PCT in those died was significantly higher than that in those survived.Whereas,serum level of CRP and WBC count elevated in both groups,but the difference between the two groups did not reach a level of statistical significance.Conclusion Serum level of PCT can be used as an early indicator for judgment of sepsis for a patient with infection and reflection of severity of illness.

Objective To observe the effect of 1,25(OH)_2D_3 on expression of vitamin D receptor (VDR), tumor necrosis factor α (TNF-α) and transforming growth factor β1 (TGF-β1) in rat peritoneal mesothelial cells (RPMCs) stimulated by lipopolysaccharide (LPS), so as to provide some evidence for clinical use of 1,25 (OH)_2D_3 on peritoneal dialysis-associated peritoneal inflammation. Methods RPMCs were isolated, cultured and passaged by enzymaticdisaggregation, then identified by phase contrast inverted microscope, transmission electron microscope with immunocytochemistry method. RPMCs were incubated with LPS (1,10,100 mg/L) and LPS (10 mg/L) for 2,6,12 hours, or stimulated by 1,25(OH)_2D_3 (10~(-8) mol/L, 10~(-7) mol/L, 10~(-6) mol/L) after incubated with LPS (10 mg/L) for 2 hours. RPMCs in the control group were justincubated with medium. Expression of VDR mRNA and protein was detected by RT-PCR and Western blot. In addition, ELISA was performed to investigate the changes of TNF-α and TGF-β1 in culture medium. Results Compared with control group, the expression of VDR mRNA and protein was decreased in LPS group (P<0.05). LPS could significantly induce the expression of TNF-a and TGF-β1 in RPMC (P <0.01), which could be partially reversed by different concentrations of 1,25 (OH)_2D_3 (P<0.01). Conclusions 1,25 (OH)_2D_3 can reverse the decrease of VDR mRNA and protein induced by LPS as well as the induction of TNF-a and TGF-β1 up-regulated by LPS in RPMC in a dose- and time-dependent manner. Our research provides experimental evidence of VDR ameliorating peritoneal dialysis-associated peritoneal inflammation and peritoneal fibrosis.

Objective To analyze the clinical,molecular and genetic features of a Chinese family with WalkerWarburg syndrome(WWS).Methods The clinical data of the proband and his family members were collected.Genomic DNAs from the patient and his parents were extracted with standard procedures from the peripheral blood leukocytes.Polymerase chain reaction and DNA direct sequencing were employed to analyze all of the 20 exons of the POMT1 gene to determine the mutation,and the relationship between genotype and phenotype was analyzed.Results The proband presented with delayed psychomotor development,muscle hypotonia and early joint contractures,his serum creatine kinase was elevated moderately and the brain magnetic resonance imaging (MRI) displayed brain structural malformations,cerebellar cyst,bilateral dilatation of the lateral ventricle,cerebellum and brainstem dysplasia.Further genetic testing detected a compound heterozygous mutation of c.313C ＞ T,p.Arg105Cys inherited from his father,a frameshift mutation c.2208delG,p.Trp736X inherited from his mother,both of which were known as pathogenic mutations.Conclusions According to the study,the proband carried compound heterozygous mutation of POMT1 gene,and his parents were heterozygous carriers,which is consistent with autosomal recessive inheritance.The child is definitely diagnosed as WWS.Genetic counseling and prenatal diagnosis are available for this family.

Objective To evaluate the choices and surgical skills for tension-free femoral hernia repair under local anesthesia. Methods The clinical data of 109 nonincarcerated femoral hernia patients were summarized from December 2002 to December 2009. Patients were divided into 3 groups according the time period at which the surgery was performed. 85 patients from 2002 to 2008 were divided into 2 groups,45 cases treated with preperitoneal repair ( preperitoneal group), and the other 40 cases with mesh-plug repair (plug group). The 24 cases admitted from January 2009 to December 2009 received modified preperitoneal repair. Operation time, VAS, length of hospitalization, incidence of recurrence, foreign body feelings and seroma were compared among the three groups. Results All the 109 patients were repaired under local anesthesia, and there was no perioperative death. The statistical indicator value of incidence of recurrence, foreign body sensation and seroma in preperitoneal group was lower than plug group (P ＜0.05). The modified preperitoneal repair was better in operation time, VAS, length of hospitalization than preperitoneal group (P ＜ 0.05). Conclusions Modified preperitoneal repair under local anesthesia is the choice for treating femoral hernia without incarceration. Modified preperitoneal repair is faster, more minimally invasive and faster recovery.

One hundred patients with early diabetic nephropathy were randomly divided into control group and study group with 50 cases in each group.All patients received conventional antidiabetic therapy with valsartan tablets 80mg, q.d;patients in study group were given additional TCM Jiawen Dihuang decoction.TCM syndrome scores, relevant biochemical testing and renal function changes were evaluated before and after treatment in two groups.After 8 weeks of treatment, the results showed than the TCM scores in both groups were significantly reduced (study group: 18.9±1.6 vs.7.2±5.1, control group 18.8±1.5 vs.10.3±6.2.both P<0.05);the improvement rate of TCM syndrome in study group was significantly higher than that of control group (90% vs.68%, x2=5.3,P<0.05);and the improvement of relevant biochemical index and renal function in study group was more marked than that in control group.The study indicates that the integrated TCM and Western medicine can enhance the efficacy in treatment of early diabetic hephropathy.

Objective To build a systematic,comprehensive,high efficient and maneuverable follow-up system in multi-disciplinary team(MDT).Methods Comparing with abroad follow-up practical management,the advantages and disadvantages were analyzed by using multiple follow-up forms and the construct of staffs to guide and evaluate the postoperative patients in colorectal carcinoma at the beginning of follow up system.Results Follow-up system was made rationalized,and an effective follow-up model was built up to extend in MDT.Conclusion Following up the present situation with patients of colorectal cancer in this country,the correct direction which is based on current follow-up system would be put out.That would be the important study to improve the medical treatment in next stage.

Objective:To analyze the risk factors associate with apex or basal positive surgical margins in patients after radical prostatectomy.Methods:During the period from January 2013 to December 2017, data was collected in 180 patients undergoing radical prostatectomy in Urological department of Peking University Cancer Hospital. Surgical margins were stated negative, positive, apex positive, basal positive. Dichotomous logistic regression analysis was used to evaluate the age, total prostate volume, biopsy positive cores, D’Amico risk classification, tumor pathology stage, Gleason score, tPSA, f/tPSA and pelvic lymph nodes metastasis with the PSMs.Results:PSMs were detected in 97 cases, including 78 cases with positive apex, 51 cases with positive basal, and 83 cases with negative margin, the PSMs proportion was 53.9%. In univariable analysis, pT 3b( OR=6.871, P=0.010), pT 4( OR=12.13, P<0.05), Gleason≥8( OR=4.989, P=0.005), pelvic lymph nodes metastasis( OR=9.516, P=0.043) associated with higher proportion of PSMs. In multivariable analysis, pT 3b( OR=5.782, P=0.030), pT 4( OR=10.15, P<0.05), Gleason≥8( OR=11.13, P=0.012) were the independent factors positively associated with higher proportion of PSMs. In univariable analysis, pT 3b( OR=4.040, P=0.026), Gleason≥8( OR=2.390, P=0.010) associated with higher proportion of apex positive. In multivariable analysis, Gleason≥8 ( OR=1.980, P=0.030) was the only independent factor associated with higher proportion of apex positive. In univariable analysis, D’Amico high risk ( OR=1.847, P=0.035), pT 4 ( OR=1.780, P=0.001) associated with higher proportion of basal positive. In multivariable analysis, D’Amico high risk ( OR=1.540, P=0.041) was the only independent factor associated with higher proportion of basal positive. Conclusions:In patients radical prostatectomy, pathology staging and Gleason score were associated with positive surgical margins.Gleason score was associated with positive apex margins, and D’Amico risk classification was associated with positive basal margins.