Objective To evaluate the clinical value and relationship between the serum levels of the Pro-gastrin-releasing peptide 31-98 (ProGRP) , neuron-specific enolase NSE and the different pathohistology types of lung cancer. Methods 353 lung cancer patients were divided into two groups according to pathohistology types: SCLC group( n = 96), NSCLC group( n = 257). 90 lung benign lesion were taken as control group. ProGRP and neu-ron specific enolase in all patients were detected by ELISA. The levels of the ProGRP, NSE and the clinical value were compared among lung cancer,lung benign lesion patients and the different pathohistology types of lung cancer patients . Results The levels of the ProGRP and NSE of SCLC and NSCLC group were higher obviously than that of lung benign lesion( P <0.01 ). In SCLC diagnosis, the sensitivity, specificity, Youden index and Kappa value of the ProGRP and NSE were O. 7708,0. 9444,0. 7153,0.7111 and 0. 7604,0. 8778 ,0. 6382 ,0. 6355 in the monomial de-tection ; Those indexes above were 0.7604,0. 9667,0.7271 and 0. 7221 in combined assay of ProGRP + NSE( on se-quence test) ; and were O. 8229,0.9000,0. 7229 and 0. 7209 in combined assay of ProGRP + NSE( on parallell test). In NSCLC diagnosis,the above indexes were all lower. Conclusions in SCLC diagnosis,the detection of the serum ProGRP is superior to the detection of NSE, the combined assay of ProGRP + NSE (on parallell test) and Pro-GRP + NSE( on sequence test) are superior to the monomial detection of the ProGRP or NSE,and the combined as-say of ProGRP + NSE(on parallell test) is superiro to ProGRP + NSE(on sequence test) ; The diagnosis value of the monomial arid united detection of ProGRP and NSE to NSCLC is not as expected.

Objective To investigate the CT imaging features of pneumonic type Bronchio-loalveolar carcinoma(BAC) and the value of CT-guided percutaneous puncture biopsy in pneumonic type BAC.Methods Twenty-five cases of suspected pneumonic type BAC were biopsied with CT-guided percutaneous puncture.GE 64-slices plain and post contrast CT scans were performed in all patients.Two radiologists finished imaging determination.Site of puncture was selected in suspicious areas of the tumor.The negative pressure aspiration needle were used to be biopsy in the ideal location after vertically into the needle and again performed CT scanning were performed to observe the complications such as hemorrhage,pneumothorax.Specimens were fixed by formalin.Results Twenty-five samples were successfully got from 25 patients.Pathology data showed that 14 cases were pneumonia with BAC,6 cases with pneumonia,2 cases with offungus infection,and 3 cases with caseous pneumonia.Of 14 cases (71.4％) with pneumonia type BAC,CT images of 10 cases showed air bronchogram of lung tissue,5 cases(35.7％) with alveolar gas cavity or cavity of lung tissue,5 cases(35.7％) with ground glass opacity and multiple nodules.Enhanced CT scanning the area of consolidation showed that 11 cases(78.6％) were with mixed low density area angiography and the mean peak time was 90 s,9 cases (64.2％) were with the time density curve of speed up and slow down type.Conclusion The method of CT guided lung biopsy combined with typical imaging findings can enhance early diagnosis rate of pneumonia type BAC.Meanwhile CT feature of pneumonia type BAC shows honeycomb air cavity,void,angiographic sign,dead branches syndrome,multiple peripheral acinar nodules and ground glass density.Enhanced scan area of consolidation shows visible angiogran sign,slow drop type of time density curve of a fast rise.

Objective To investigate the relationship between polymorphism of interleukin-1β(IL-1β)-31,-511C/T and chronic obstructive pulmonary disease.Methods Two hundred and sixty patients with chronic obstructive pulmonary disease (COPD) were selected as our subjects who were hospitalized in General Hospital of Kailuan from January 2009 to June 2012.At same time,the 260 healthy controls were recruited in medical examine center.The data was collected by the physical examination and a unified questionnaire.Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IL-1β in serum.Polymerize chain reaction-Restriction fragment length polymorphism (PCR-RLFP) was used to detect the genotypes of IL-1β (-31,-511).Multivariate logistic regression was used to analyze the relations between risk factors with susceptibility of COPD.Results The level of serum IL-1β was (3.92 ± 0.42) μg/L in COPD group,higher than that in control group ((2.69 ± 0.11) μg/L,t =12.889,P ＜ 0.001).The frequency of genotype of IL-1β-31 site in COPD group were 20.8％ (54/260) for TT,58.1％ (151/260) for CT and 21.2％ (55/260) for CC respectively.Meanwhile IL-1β-31 genotype rate were 19.2％ (50/260),58.8％ (153/260) and 21.9％ (57/260) respectively in control group and no significant difference was found between two groups (x2 =0.203,P =0.904).The frequency of genotype of IL-1β-511 site were 20.0％ (52/260) for CC,63.1％ (164/260) for CT and 16.9％ (44/260) for TT in COPD group.The three genotype rate in control group were 21.9％ (57/260),60.8％ (158/260) and 17.3％ (45/260) respectively,and no significant difference was found between two groups (x2 =0.352,P =0.838).Moreover there was also no significant difference in terms of gender(P ＞ 0.05)Conclusion The concentration of IL-1β in serum in COPD group was higher than in control group.The polymorphism of-31 and-511 were proved non association with COPD.

Total 306 patients with early stage diabetes were enrolled in the study, after follow-up for 67 ± 8 months, the data of 288 cases were analyzed with survival analysis method. At the end of study 64 out 288 patients had high serum uric acid and the remaining 224 had normal uric acid levels. The prevalence of dominant proteinuria and reduced GFR were significantly higher in patients with high serum uric acid than those with normal serum uric acid (47. 36% vs 30. 29% and 66. 14% vs 37.72%, respectively, both P <0. 05). The results suggest that high level of serum uric acid is a risk factor for the progress of diabetic nephropathy.

Objective To study the relationship and clinical significance of the serum level of Pro-gastrinreleasing peptide31-98 (ProGRP)and bronchoalveolar lavage fluid for small cell lung cancer of different TNM staging.Methods 96 cases of SCLC with definite pathohistological typing were divided into stage Ⅰ～Ⅱ SCLC group (n=30),stage ⅢSCLC group (n=31),stage IVSCLC group (n=35),and the benign cases (n=90)were taken as control.Using enzyme-linked immunoserbent assay ( ELISA),the serum levels of ProGRP and bronchoalveolar layage fluid of all patients were detected,meanwhile the neuronspecific enolase were served as controls.The relation between serum and bronchoalveolar lavage fluid ProGRP level and small cell lung cancer of different TNM staging was analyzed.Results The serum level of ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (295.33±118.56),(421.13±196.66),(758.76±326.19)and (29.68±16.32)μg/mol,respectively (P＜0.01 ).The level in bronchoalveolar lavage fluid ProGRP were ( 516.67 ±208.45),( 1170.55±414.65 ),( 1739.12±696.08 )and (49.23±22.50)μg/mol,respectively (P＜0.01 ).The serum level of NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (10.36±6.76),(24.19±10.88 ),(35.76±17.30)and (9.70 ±5.28)mg/mol.The level in bronchoalveolar lavage fluid NSE were (16.66±11.62),(45.47±20.74),(65.18±29.87)and (9.70±5.28)mg/mol,respectively (P＜0.01).The positive rate of serum ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were 0.6000,0.7097,0.8286 and 0.0667 ,respectively(P＜0.01).The positive rate in bronchoalveolar lavage fluid ProGRP were 0.6333,0.7419,0.8571 and 0.0444,respectively (P＜0.01).The positive rate of serum NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group ,stage Ⅳ SCLC group,and the benign group were 0.2333,0.6774,0.8000 and 0.2222.The positive rate in bronchoalveolar lavage fluid NSE were 0.2667,0.7097,0.8286 and 0.2667 ,respectively(P＜0.01 ).Both the ProGRP level and positive rate in serum and bronchoalveolar lavage fluid were obviously higher in stage Ⅰ～Ⅱ,Ⅲ,and Ⅳ SCLC group than in benign group (P＜0.01 ),both the ProGRP and NSE level and positive rate in bronchoalveolar lavage fluid were obviously higher than that in the serum.The positive rate in serum and bronchoalveolar lavage fluid ProGRP in stage Ⅰ～Ⅱ SCLC group were obviously higher than that in the NSE (P＜0.01),but there was no significant difference in stage Ⅲ and Ⅳ SCLC group.Conclusion ProGRP level in serum and bronchoalveolar lavage fluid have great value to the diagnosis and clinical stages of SCLC,especially the early diagnosis,ProGRP is better than NSE;As to the diagnosis of small cell lung cancer of different TNM staging,ProGRP detection in bronchoalveolar lavage fluid is better than in serum.

[Objective] To standardize integrated traditional and western treatment programs of lower urinary infection and evaluate its effect and to insure the safety. [Methods] TCM syndrome type of lower urinary tract infection is divided into Xuelin type, gaolin type, laolin type, qilin type, relin type. Each type col ects separately 60 patients. Every 60 patients are randomly divided into experimental and control groups.The way to treat the patients for the con-trol group must be in accordance with the norms of western medicine treatment of anti-infection. By contrast, the way that the patients from the experi-mental group should be based on the western medicine treatment, simultaneously what is to be emphasized is that the treatment must also be according to Chinese medicine syndrome type plus Chinese herb. The three elements efficacy, cost-effectiveness and security analysis are used to evaluate the differences between the two groups. [Results]The experimental group of relin type and qilin type has no statistical y significant difference in the efficacy of the control group.The efficacy of experimental group of xuelin type, gaolin type and laolin type is better than the control group,and cost-effectiveness ratio has no significant difference.There is no serious adverse reaction. [Conclusion] Screening of lower urinary tract infection patients with blood type, cream drench type, combination of traditional Chinese and western medicine treatment, can improve the curative effect.

In the past ten years, 52 patients with double-chambered right ventricle (DCRV) were operated on in Xijing Hospital. They constituted 2.2% (52/1881) of all patients with congenital heart diseases. Of them, there were 32 males and 20 females, whose ages ranged from 4.5 to 30 years old. In one patient there was pure DCRV, and the remaining 51 patients DCRV was associated with other congenital cardiac anomalies, in which VSD was the most common (50), followed in order by pulmonary stenosis (6), aortic valve prolapse (4), atrial septal defect (2), and subaortic stenosis (1). The repair of DCRV and other intracardiac defects was done through the right ventricolotomy in 47 cases and through the right ventricolotomy plus atriotomy in 2 cases. In another 2 cases the operation was done via the right atriotomy and 1 case pulmonary arteriotomy, and only VSDs were closed, but DCRVs were missed. The major postoperative complications included cardiac arrhythmia (11) and low output syndrome (8). Three patients died, with the operative mortality of 5.8%. In this series, according to characteristics of the anomalous muscle bundle and its resulting obstruction, we divided 52 case DCRVs into two types: fibromuscular diaphragmatic type (24 cases, 44.7%) and muscular bundle-gap type (28 cases, 55.7%). In both types, there were not only hypertrophied anmalous muscle bundles on the septal side, but also hypertro-phied ventricoinfundibulum fold on the parietal side. In a few cases, the ventricoinfundibulum fold was more hypertrophic than the anomalous muscle bundle on the septal side.

Objective To explore the cerebrovascular reactivity of the patients with cerebral infarction by transcranial color Doppler ultrasound (TCCD) and breath holding test.Methods TCCD was used to record the color Doppler imaging and Doppler spectrum and to measure peak velocity,mean velocity of double side middle cerebral artery(MCA) in thirty two normal persons and thirty seven patients with cerebral infarction confirmed by CT or MRI.Breath holding test was performed to record the Doppler spectrum and breath holding time and to calculate breath holding index(BHI).Results ①The peak velocity of MCA of the damaged side was abnormally increased by 35.1% and decreased by 40.5% .②The BHI of the damaged side was significantly lower than that of undamaged side and that of control group (P

Objective To investigate D-Dimer, C-reactive protein and brain natriuretic peptide in clinical diagnosis of patients with pulmonary embolism and to compare the sensitivity, specificity and accuracy.Methods 45 cases of large area pulmonary embolism and 45 cases of small areapulmonary embolism were selected, at the same time, 45 cases of normal people were selected as the control group.D-dimer, CRP and BNP levels were detected and compared of each group before and after treatment.The relevance between D-Dimer, CRP, BNP levels and pulmonary embolism was analyzed by Logistic analysis.The gold standard of pulmonary embolism with D-dimer test, CRP test and BNP test were compared.the sensitivity, specificity and accuracy ofD-dimer test, CRP test and BNP test wer calculated.Results D-Dimer, CRP and BNP levels of the large area group and small area group were significantly higher than those in the control group before treatment (P<0.05);the D-Dimer, CRP and BNP levels of large area group were significantly higher than those in small area group (P<0.05).After treatment, the D-Dimer, CRP and BNP levels of large area group and small area were significantly decreased (P<0.05), and had no significant difference compared with normal control group.Logistic analysis showed that there was significant positive correlation between plasma, D-Dimer, CRP and BNP levels and pulmonary embolism (r=3.11, P<0.05;r=4.36, P<0.05;r=2.86, P<0.05) .There was no significant difference of sensitivity, specificity and accuracy of three methods.Conclusion There is a positive correlation between the occurrence of pulmonary embolism and D-dimer, CRP, BNP levels, which are important indexs to evaluate the patient's condition, it has very important clinical value.

Objective To investigate the distribution of pathogens in adult patients with community-acquired pneumonia (CAP) in Tangshan area. Methods The clinical data of 530 hospitalized patients with CAP were retrospectively collected in department of respiratory medicine from 6 hospitals in Tangshan area from October 2011 to September 2012. The sputum samples were isolated and cultured. Results A total of 195 strains were isolated from 530 patients with CAP. The most common types of pathogens included Klebsiella pneumoniae (64 strains,12.08%), Streptococcus pneumoniae (24 strains, 4.53%) and Bauman Acinetobacter (19 strain, 3.58%). The detective rates of Klebsiella pneumoniae and Pseudomonas aeruginosa were significantly higher in patients with basic diseases than those of patients without basic diseases (P<0.05). The detective rates of Klebsiella pneumoniae and Streptococcus pneumoniae were significantly higher in patients not taking antibiotics than those of patients taking antibiotics (P<0.05). The detective rates of Klebsiella pneumoniae, Bauman Acinetobacter and Pseudomonas aeruginosa were significantly higher in the age group≥60 years than those in the age group<60 years (P<0.05). The detective rates of Klebsiella pneumoniae were significantly increased with increased levels of PORT (P<0.05). There were no significant differences in the detective rates of pathogens between different regions and different seasons (P>0.05). Conclusion The gram-negative bacterial pathogens were the majority isolated from patients with CAP in Tangshan area. And Klebsiella pneumoniae was the primary bacteria. Patients with serious illness, above 60 years old, without antibiotic treatment before hospitalization, with basic diseases and above PORTⅢlevels should be given treatment of anti-gram-negative bacteria.