ABSTRACT:Cervical cancer is the most common malignancy of the female genital tract. Its incidence is still increasing with lower average onset age. Mass screening should be above prevention and treatment, and three screening programs, including the optimal program, the general program, and the basic program, are currently adopted in China. Cervical intraepithelial neoplasia (CIN), a precancerous lesion, can be confirmed by the combined use of cytology, colposcopy, and histology and then managed with standardized approach. Human papillomavirus (HPV) infection is an essential factor during the development of cervical cancer, and persistent infection of high-risk HPVs may lead to CIN and subsequently develop to cervical cancer. High-risk HPV detection can be used for screening, differentiation of the atypical squamous cells of undetermined significance /low-grade squamous intraepithelial lesion (ASCUS/LSIL) triage, and follow-up after treatment. The modern strategy of HPV infection is “to treat the disease, CIN, means to treat the virus, HPV”. The licensing of HPV vaccine is an important event in cancer prevention, and this vaccine can be used for the primary prevention. However, early diagnosis and early treatment are still the most basic strategies for cervical cancer prevention and treatment.

Objective To evaluate the trend of cervical cancer incidence and mortality rates during 1989-2008 in Chinese women,so as to inform the development of relevant policies and strategies in China. Methods The incidence and mortality rates of cervical cancer during 1989-2008 in urban and rural areas were calculated based on the data from the National Cancer Registry Database.Age-standardized rates were calculated using the Chinese population of 1982 and World Segi’s population of 1985.Joinpoint regression analysis was performed to obtain annual percentage changes(APC)so as to assess the trend of incidence and mortality rates over the period from 1989 to 2008.Results The crude incidence rate of cervical cancer in Chinese women increased from 3.06/10⁵ in 1989-1990 to 11.87/10⁵ in 2007-2008(from 4.96/10⁵ to 11.98/10⁵ in urban registration areas and from 2.39/10⁵ to 11.77/10⁵ in rural registration areas).The crude mortality rate slightly increased from 2.19/10⁵ in 1989-1990 to 3.20/10⁵ in 2007-2008(from 3.21/10⁵ to 2.56/10⁵ in urban registration areas and from 1.82/10⁵ to 3.75/10⁵ in rural registration areas).Generally,the upward trends of crude incidence rates were shown over the year 1989-2008,with an APC of 14.4% after 1997 in urban areas and 22.5% after 1999 in rural areas.After age standardization of world population,the APC of incidence rates in recent decade in urban areas remained stable,and the one in rural areas slightly decreased.Although the overall crude and world age-standardized mortality rates had no significant changes during 1989-2008,the crude mortality rates increased by 8.1% annually after 1999.The upward trends were also shown for crude and world age-standardized mortality rates in urban areas after 2001 with an APC of 7.3%.The crude mortality rates in rural areas increased by 3.9% annually during 1989-2008,but no significant change was found after age standardization.Conclusions Over the last decade,the cervical cancer incidence and mortality rates ascended by year in China.It is particularly urgent to establish a comprehensive prevention and control system that combines cervical cancer screening and human papillomavirus vaccination,so as to reduce the burden of cervical cancer in Chinese women.

ABSTRACT:Metabonomics (or metabolomics) aims at the comprehensive and quantitative analysis of the wide arrays of metabolites in biological samples. Metabonomics has been labeled as one of the new "-omics" joining genomics, transcriptomics, and proteomics as a science employed toward the understanding of global systems biology. It has been widely applied in many research areas including drug toxicology, biomarker discovery, functional genomics, and molecular pathology etc. The comprehensive analysis of the metabonome is particularly challenging due to the diverse chemical natures of metabolites. Metabonomics investigations require special approaches for sample preparation, data-rich analytical chemical measurements, and information mining. The outputs from a metabonomics study allow sample classification, biomarker discovery, and interpretation of the reasons for classification information. This review focuses on the currently new advances in various technical platforms of metabonomics and its applications in drug discovery and development, disease biomarker identification, plant and microbe related fields.

ABSTRACT:Objective To compare the chemical compositions between Dendrobium candidum (D. candidum) and Dendrobium nobile (D. nobile). Method Relative area and content of every chromatographic peak in the ammonic chloroform extracts of D. candidum were compared with those of D. nobile with high performance liquid chromatography-mass spectrometry. Results The relative area of alkaloids accounted for 2.34% and 41.87% in D. candidum and D. nobile, respectively. The relative area of 25 identical compositions took up 97.12% in the total area of D. candidum and 50.09% in that of D. nobile, and contents of 23 composition were higher in D. candidum than those in D. nobile. Conclusions The quantity and contents of alkaloids are remarkably different between D. candidum and D. nobile. However, D. candidum has a higher quality than D. nobile in terms of the same chemical compositions.

老年性痴呆（Alzheimer's disease ,AD）是老年人的常见病，60岁以上发病率约为5%，已成为影响家庭和社会发展的重要制约因素，引起全世界的广泛关注，本文从４方面论述了老年性痴呆的发病机理，并提出了药物治疗的策略。

ABSTRACT: Microbubble contrast agents for ultrasound (US) have been developed and clinically applied in recent years. Contrast-enhanced ultrasound (CEUS) has been widely used in the imaging of liver and other organs such as kidney， pancreases， spleen， prostate， ovarian， uterus as well as abdominal trauma, showing promising values in the diagnosis and differential diagnosis of various diseases. This article reviews the recent development and future protential clinical applications of CEUS.

目的 观察抗血小板药物阿司匹林、氯吡格雷及两药合用对兔动脉粥样硬化病变进展的抑制作用。方法 将49只雄性日本大耳白兔随机分为正常对照组（n=9）、模型对照组（n=10）、阿司匹林组（n=10）、氯吡格雷组（n=10）及合用组（n=10）。后4组建立高胆固醇饲料并免疫损伤诱发的主动脉粥样硬化模型。测血清血脂和C反应蛋白(CRP)浓度。观察主动脉组织病理形态学改变并定量分析病变程度，免疫组织化学方法测定斑块部位的巨噬细胞和平滑肌细胞阳性百分率。结果 阿司匹林和氯吡格雷均能明显减轻动脉粥样硬化病变，降低血清

目的 了解血清抗甲状腺球蛋白抗体（anti-TgAb）和抗甲状腺过氧化物酶抗体（anti-TPOAb）测定对甲状腺疾病的临床诊断意义。方法 采用化学发光免疫分析（CLIA）法测定389例患有各种甲状腺疾病及其相关疾病（包括经病理证实的桥本甲状腺炎、Graves病、结节性或毒性结节性甲状腺肿、甲状腺滤泡上皮细胞良、恶性肿瘤；临床诊断的亚急性甲状腺炎、其他内分泌疾病和甲状腺功能正常的其他自身免疫性疾病）患者和45例健康对照者的anti-TgAb和anti-TPOAb水平，并计算其阳性率。结果 不同疾病患

ABSTRACT:Ultrasonic elastography (UE) is a new technique used in diagnosis of breast tumors. Approaches to determine the potential influential factors and to increase the diagnostic accuracy of UE include: understanding the principles of UE and mastering the correct examination methods; further research on the relevant pathologic changes of breast tumors under UE; establishment of the Logistic model of malignant breast tumors based on the ultrasound characteristics. Biopsy remains an option for the atypical lesions.

ABSTRACT: Facing the complicated life phenomemon, both metabonomics and pharmaco-metabonomics take an organic conception of the human body, which conforms to the way of thinking of traditional Chinese medicine(TCM). The application of metabonomics and pharmaco-metabonomics in the modernization of TCM will deepen the evaluation of the therapeutic effects of TCM, the study of intrinsic quality of TCM syndrome and the treatment by differentiation of syndrome, facilitate the integration of TCM with modern biological science and technology, promote the modernization of TCM, and provide a new space for the development of TCM.

ABSTRACT:The early diagnosis, surgical treatment, and comprehensive treatment of primary liver cancer (PLC) have advanced greatly in recent years. Both the survival and quality of life of patients with PLC have remarkably improved. Further advances in basic research may provide new direction of the management of PLC.

Cesarean scar pregnancy is an uncommon ectopic gestation. Without timely and proper management,it may cause major bleeding,uterine rupture,and other life-threatening complications. The causes of this condition remain unclear,and no standardized management has been available,although some medical and surgical treatment modalities have been suggested. The main treatment objectives include preventing massive blood loss,preserving the uterus function,and maintain the women’s health and quality of life. Current data do not support expectant management. After early diagnosis,single or combined medical and surgical treatment options should be provided to avoid uterine rupture and haemorrhage,so as to preserve the uterus and thus the fertility.

ABSTRACT:Objective To evaluate the role of preoperative ultrasonography in detecting early cervical lymph node metastasis in differentiated thyroid carcinoma. Methods Data were reviewed retrospectively from medical records between July 2003 and July 2005, in which patients were divided into 2 groups: group A (study group): 51（55 sides）patients of differentiated thyroid carcinoma patients with impalpable node but with ultrasonic positive nodal metastasis; group B (control group): 57 (64 sides) patients with preoperative palpable cervical lymph nodes. All patients had been undergone modified neck dissection. The preoperative ultrasonographic results and the preoperative pathologic finding had been compared in group A. Results In 51 patients (55 sides) of preoperative positive ultrasonography 49 sides had been demonstrated cervical lymph nodes metastasis pathologically. The sensitivity of ultrasonography was 89.1%. Ultrasonography detected cervical lymph node believed to be uninvolved by physical examination in 41.2% of patients. 65.5% of the cervical lymph metastasis was multilevel and the most frequent involvement site was middle neck and the involvement rate was 70.9% in ultrasonography. 75.5％ of the cervical lymph metastasis was multilevel and the most frequent involvement site was level Ⅲ(65.3％)in pathologic finding. Conclusions Preoperative ultrasonograpy is a mainstay in detecting cervical lymph nodes metastasis in thyroid cancer patients. It can detect the early cervical lymph node metastasis and localize the position of the cervical metastasis. All the thyroid cancer patients should undergo preoperative ultrasonography and the extent of the neck dissection relies on the preoperative ultrasonic finding of the neck.

ABSTRACT:The risk factors of traffic crash include drinking/drunk drive, accident proneness, fatigue driving, speeding, and poor vehicle quality. This article introduces the protection, emergency treatment, and basic scientific research of road traffic injury (RTI). As a public health issue, RTI is preventable, and personal factor is a key problem. It is important to establish an accurate and comprehensive RTI database, which may provide necessary information for the epidemiological research and crash prevention. The author also gives some suggestions on road traffic safety development in our country.

目的 研究脊髓型颈椎病手术治疗方法及影响疗效的因素。方法　选取365例脊髓型颈椎病患者，全部实施颈前路减压及自体髂骨移植或钛网、钛板固定融合术，其中5例于术后3～6个月再次手术。术后随访2年6个月～6年，平均3年4个月，分析其手术治疗方法及影响疗效的因素。结果　临床功能评价：优175例(47.94%)、良129例(35.34%)、可44例(12.05%)、差17例(4.66%)。结论 脊髓型颈椎病前路手术减压效果较好，手术时机、病变程度及手术技术等是影响疗效的重要因素。

ABSTRACT:Objective To evaluate the usefulness of serum alpha-fetoprotein (AFP) in clinical diagnosis and screening for hepatocellular carcinoma (HCC). Methods Totally 290 HCC patients，48 liver cirrhosis patients, and 49 healthy subjects were enrolled in this study. Serum AFP analysis was performed to investigate the correlation between the serum AFP level in HCC and the clinical or biochemical parameters of the disease, which included the size and number of tumor and the TNM stage. Sensitivities and specificities of AFP in HCC prediction at different cut-off levels were determined. Results The serum AFP level was significantly higher in HCC patients than in liver cirrhosis patients (P=0.0274) and healthy subjects (P=0.0001). Among 290 HCC patients，95 patients (32.8%) were AFP-negative (AFP＜20μg/L＝,195 (67.2%) were AFP-positive (AFP≥20μg/L). Sensitivity and specificity of AFP at 20μg/L cut-off was 67.2% and 29.2%, respectively, and the positive and negative predictive value was 85.2% and 12.8%, respectively. Sensitivity of AFP at 400μg/L cut-off was only 42.8%. Serum AFP levels were significantly different among HCC with different tumor size (P=0.0009), tumor number (P＝0.0001), and TNM stage [TNM I vs. TNM Ⅲ-Ⅳ (P=0.0001);TNM Ⅱ vs. TNM Ⅲ-Ⅳ (P=0.0003)]. Conclusions Increased serum AFP level is highly suggestive in HCC diagnosis. Combined with other imaging examinations, AFP level can be used for the screening of high risk population and for the follow-up of AFP-positive patients.

目的 探讨河北省正常人群肺功能的生理预计值及其不同生活环境、年龄、身高、体重等因素与肺功能的关系。方法 2002年8～10月对进行过基础体检并确定为正常的1587名不同年龄段人群采用便携式肺功能仪进行肺容量及肺通气量检测，分析不同地域、年龄、性别、身高、体重等因素对肺功能的影响。结果 检测的各项肺功能指标城乡之间差异无显著性（P>0.05）；不同性别之间差异有显著性（P=0.000）；多数肺功能指标在男12～16岁、女12～14岁为肺功能增长突增期，肺活量（VC）、用力呼气肺活量（FVC）、一秒量（F

ABSTRACT:High mobility group box-1 protein (HMGB1) has recently been shown as a crucial late mediator of inflammation and sepsis, and is involved in mediating multi-organ functional lesions, including acute lung, liver, and intestine injuries. As a delayed inflammatory cytokine, HMGB1 provides a wider therapeutic time window for clinical intervention. HMGB1 has been proven to be a promising therapeutic target to prevent the development of multiple organ dysfunction syndrome in experimental models of severe sepsis. The pharmacological strategies include neutralization of antibodies or specific HMGB1 antagonists, suppression of HMGB1 secretion (ethyl pyruvate, agonists for α7-nicotinic acetylcholine receptors), and down-regulation of HMGB1 expression (sodium butyrate, signaling inhibitors for Janus kinase/signal transducer and activator of transcription).

Ａｂｓｔｒａｃｔ: Ｏｂｊｅｃｔｉｖｅ Ｔｏ ｓｔｕｄｙ ｄｉｆｆｅｒｅｎｔｉａｔｉｏｎ ｏｆ ｈｕｍａｎ ｂｏｎｅ ｍａｒｒｏｗ-ｄｅｒｉｖｅｄ ｍｅｓｅｎｃｈｙｍａｌ ｓｔｅｍ ｃｅｌｌｓ(ＢＤＭＳＣ) ｉｎｔｏ ｂｌｏｏｄ ｖｅｓｓｅｌ ｅｎｄｏｔｈｅｌｉａｌ ｃｅｌｌs ｆｏｒ ｉｄｅａｌ ｃｅｌｌ ｏｒｉｇｉｎ ｏｆ ｃｏｍｐｌｅｘ ｏｒｇａｎ ｔｉｓｓｕｅ ｅｎｇｉｎｅｅｒｉｎｇ ｖａｓｃｕｌａｒｉｚａｔｉｏｎ ａｎｄ ｉｎｊｕｒｅｄ ｔｉｓｓｕｅ ｒｅｐａｉｒｉｎｇ ｂｙ ｃｅｌｌ ｔｒａｎｓplantａｔｉｏｎ． Ｍｅｔｈｏｄ Ａｆｔｅｒ ｄｉｆｆｅｒｅｎｔ ｄａｙｓ ｏｆ ｉｎｄｕｃｔｉｏｎ ｗｉｔｈ ｖａｓｃｕｌａｒ ｅｎｄｏｔｈｅｌｉａｌ ｇｒｏｗｔｈ ｆａｃｔｏｒ(ＶＥＧＦ)ａｎｄ ｂａｓｉｃ ｆｉｂｒｏｂｌａｓｔ ｇｒｏｗｔｈ ｆａｃｔｏｒ(ｂＦＧＦ)ｉｎ ３Ｄ ｆｉｂｒｉｎ-ｇｅｌｓ ａｎｄ mａｔｒｉｇｅｌ, ＢＤＭＳＣ ａｎｄ ａｎｇｉｏｇｅｎｅｓｉｓ ｗｅｒｅ ｄｅｔｅｒｍｉｎｅｄ ｂｙ ｔｈｅ ｕｔｉｌｉｚａｔｉｏｎ ｏｆ ｍｏｒｐｈｏｌｏｇｉｃａｌ ｏｂｓｅｒｖａｔｉｏｎ,ｔｉｓｓｕｅ ｓｅｃｔｉｏｎ ａｎｄ ＣＤ３４, ＣＤ３１, vascular endothelial growth factor receptor-1(VEGFR-1, Ｆｌｔ-１), VEGFR-2(Ｆｌｋ-１), ａｎｄ ｖＷＦ ｔｈａｔ ｗｅｒｅ ｓｐｅｃｉａｌ ｆｏｒ ｂｌｏｏｄ ｖｅｓｓｅｌ ｅｎｄｏｔｈｅｌｉａｌ ｃｅｌｌs． Ｒｅｓｕｌｔ Ａｆｔｅｒ ３Ｄ-ｃｕｌｔｕｒｅｄ ａｎｄ ｉｎｄｕｃｅｄ ｗｉｔｈ ＶＥＧＦ ａｎｄ ｂＦＧＦ ｉｎ ｖｉｔｒｏ ｉｎ ｆｉｂｒｉｎ-ｇｅｌｓ ａｎｄ mａｔｒｉｇｅｌ ｆｏｒ ３-２１ ｄａｙｓ, ＢＤＭＳＣ ｅｘｐｒｅｓｓｅｄ CD34, ＣＤ３１, Ｆｌｔ-１, Ｆｌｋ-１, ａｎｄ ｖＷＦ ｃａｍｅ ｉｎｔｏ ｖｅｓｓｅｌ-ｌｉｋｅ ｃｏｎｆｉｇｕｒａｔｉｏｎ． Ｃｏｎｃｌｕｓｉｏｎ ＶＥＧＦ, ｂＦＧＦ ａｓ ｗｅｌｌ ａｓ Ｆｌｔ-１ ａｎｄ Ｆｌｋ-１, ｅｘｐｒｅｓｓｅｄ ｂｙ ＢＤＭＳＣ, ｍａｙ ｆｏｒｍ ａ ｆｅａｓｉｂｌｅ ｍｉｃｒｏｅｎｖｉｒｏｍｅｎｔ ａｆｔｅｒ ｉｎｄｕｃｔｉｏｎ ａｎｄ play ａｎ ｉｍｐｏｒｔａｎｔ ｒｏｌｅ ｄｕｒｉｎｇ ｐｒｏｃｅｓｓｅｓ ｏｆ ｂｌｏｏｄ ｖｅｓｓｅｌ ｅｎｄｏｔｈｅｌｉａｌ ｃｅｌｌ ｄｉｆｆｅｒｅｎｔｉａｔｉｏｎ ａｎｄ ｖｅｓｓｅｌ-ｌｉｋｅ ｃｏｎｆｉｇｕｒａｔｉｏｎ ｆｏｒｍｉｎｇ ｏｆ ＢＤＭＳＣ． Ｍｅｓｅｎｃｈｙｍａｌ ｓｔｅｍ ｃｅｌｌｓ ｍａｙ ｂｅ ａｐｐｌｉｅｄ to tissue ｅｎｇｉｎｅｅｒｉｎｇ ｖａｓｃｕｌａｒｉｚａｔｉｏｎ ａｎｄ ｉｎｊｕｒｅｄ ｔｉｓｓｕｅ ｒｅｐａｉｒｉｎｇ ｂｙ ｃｅｌｌ ｔｒａｎｓplantａｔｉｏｎ．

ABSTRACT:Objective To study the relationship between early spontaneous abortion and living environment, and explore the risk factors of spontaneous abortion. Methods We conducted analysis based on the interview of 200 spontaneous abortion cases and the matched control (age±2 years) by using multifactor Logistic regression analysis. Results The proportions of watching TV ≥10 hours/week, operating computer≥45 hours/week, using copycat, microwave oven and mobile phone, electromagnetism equipment near the dwell or work place, e.g. switch room≤50 m and launching tower≤500 m in the cases are significantly higher than those in the controls in single factor analysis（all P<0.05）. After adjusted the effect of other risk factors by multifactor analysis, using microwave oven and mobile phone, contacting abnormal smell of fitment material≥ 3 months, having emotional stress during the first term of pregnancy and spontaneous abortion history were significantly associated with risk of spontaneous abortion. The odds ratios of these risk factors were 2.23 and 4.63, respectively. Conclusion Using microwave oven and mobile phone, contacting abnormal smell of fitment material≥ 3 months, having emotional stress during the first term of pregnancy, and spontaneous abortion history are risk factors of early spontaneous abortion.

ABSTRACT:Objective To investigate the hand hygiene (HH) compliance and its influencing factors in order to improve the HH of healthcare workers (HCWs). Methods HH compliance of HCWs in randomly sampled departments in our hospital was observed and recorded single-blindly by specially-trained staffs using a uniform method. Results The total compliance rate of HH of HCWs was 30.2%, which varied among different departments and posts, and working areas. It was significantly higher in ward doctors than in outpatient physicians (P＜0.01). However, the compliance was not significantly different among nurses in different departments (P＞0.05). The compliance of HH of HCWs after surgical procedures (40.4%) was significantly higher than that before procedures (19.6%) (P<0.01). Conclusion The compliance of HH of HCWs remains low, which is somehow affected by factors such as departments, posts, and treatment modes.

Objective To investigate the clinical manifestations, treatment, and prognosis of gastric cancer in the elderly patients. MethodA total of 252 patients with gastric cancer who admitted to the Oncology Department of Peking Union Medical College Hospital were divided into elderly group(≥65 years)and non-elderly group(<65 years)and the clinical characteristics of these two groups were analyzed and compared. ResultsThe elderly accounted for 36.0% of all gastric cancer patients in our department. The proportion of male was significantly higher in elderly group than non-elderly group(male∶female=3.74∶1, P=0.020). Abdominal satiety and pain were the most common symptoms, which were significantly lower in elderly group(43.3% vs. 61.7%, P=0.005). However, the frequency of weight loss was significantly higher in the elderly group(15.6% vs. 6.2%, P=0.015). Significantly more elderly patients with gastric cancer were found the second tumors(12.2% vs. 2.5%, P=0.002). The most common tumor location was cardia(36.7%)in elderly group and antrum(34.6%)in non-elderly group. A small proportion(2.2%)of elderly patients had multi-original lesions, which was not found in non-elderly group. The overall rate of surgery and R0 resection rate were 77.8% and 70.9% respectively, which were similar in both groups. The overall rate of chemotherapy was 98%. The ratio was one third compared with younger patients who received three and more than three lines chemotherapy (3.3% vs. 9.3%), but did not reach statistical difference. More elderly patients chose FOLFOX / XELOX regimen(73.3%)compared with younger arm. The median survival time was 26.5 months in elderly group and 28.0 months in non-elderly group(P=0.835). Subgroup analysis showed that the median survival time of stage Ⅳ gastric cancer was longer in elderly group than in non-elderly group(22.7 months and 16.1 months, respectively; P=0.057), which was marginally statistically significant. ConclusionsMore old men may get gastric cancer. More elderly patients may present with weight loss. Cardia is the most common tumor location. The ratio of multi-original lesions and secondary tumors is higher for elderly patients. Elderly patients with good performance status can receive surgery and chemotherapy safely. The resection rate is similar between elderly and non-elderly patients. Elderly patients receive more two-drug combination regimens. The overall prognoses are similar between elderly patients and non-elderly patients.

ABSTRACT:With the development of biomolecular technology, more human papillomavirus （HPV） types have been found to be related with various diseases. High-risk HPV 16, 18, 31, 33, 45, 52, and 61 have shown causal relationship with cancers of the cervix, vulva, vagina, penis, anus, oral cavity, and oropharynx. Low-risk HPV 6 and 11 have shown causal relationship with genital warts. HPV may also cause cancer of the larynx. However, the relationships between HPV and esophagus and lung cancers are still controversial.

ABSTRACT:Objective To investigate the clinical manifestations, treatment, complications, and prognosis of patients with multiple injuries. Method The clinical data, including the causes of injury, treatment, complications, causes of death, and mortality rate, of 4519 patients were retrospectively analyzed. Results The major causes of injury were road traffic injury （2410 cases, 53.33%）, violence injury（747 cases, 16.53%）, and high falling injury （575 cases, 12.72%）. The main involved positions included head（2247 cases, 18.71%）, abdominal region and pelvis （2118 cases, 17.64%）, and thoracic region （1853 cases, 15.43%）. The major complications were shock （1497 cases, 33.13%）. The main cause of death was sepsis with multiple organ dysfunction syndrome/failure（28 cases, 82.35%）after multiple injuries, significant higher than other causes in the same period (P<0.01). Conclusions The multiple injuries have various causes of disease, and were complicated with their diverse clinical manifestations, numerous complications, and high mortalities. Further research on the integrated rescue mortality is required.

Objective To compare the effects of piglitazone and metformin on retinol-binding protein-4(RBP-4)and adiponcetin(APN)in patients with type 2 diabetes mellitus(T2DM)complicated with Non alcohol fatty acid liver disease(NAFLD). Methods Totally 60 T2DM patients complicated with NAFLD were equally and randomly divided into pioglitazone group and metform group. The levels of biochemical indicators including body mass index(BMI),glucose hemoglobin A_1C(GHbA_1C),insulin resistance(HOMA-IR),fasting blood glucose(FBG),fasting insulin(FIns),and serum triglycerides(TG)as well as serum RBP-4 and APN level were measured pre-treatment and 12 weeks after treatments. Results After 12 weeks of treaments,BMI,FBG,HOMA-IR,GHbA_1C,FIns,and TG decreased(all P＜0.05)in both piglitazone group and metform group. APN increased(all P＜0.05)in both groups. RBP-4 decreased(P＜0.05)in piglitazone group. Compare with the metform group,the levels of RBP-4,FIns,and HOMA-IR decreased and BMI increased in piglitazone group(P＜0.05). Conclusion Piglitazone is superior to metoform in decreasing RBP-4 level and HOMA-IR in patients with T2DM complicated with NAFLD.

ABSTRACT:Objective To evaluate the sensitivity of an interferon-gamma release assay T-SPOT.TB in the diagnosis of bacteriologically or histologically confirmed extrapulmonary tuberculosis. MethodTotally 31 patients with bacteriologically or histologically confirmed extrapulmonary tuberculosis in Peking Union Medical College Hospital received T-SPOT.TB assay to detect early secreting antigen target 6 or culture filtrate protein 10 peptides-specific T cells in the peripheral blood mononuclear cells(PBMCs). Results T-SPOT.TB assay showed positive results in 29 patients with extrapulmonary tuberculosis and the sensitivity was 93.5%（95% CI 84.8% - 100%). The median of spot forming cells（SFCs） in response to early secreting antigen target 6 peptides was 196/106PBMCs (interquartile range, 72-532/106 PBMCs), the median of SFCs in response to culture filtrate protein 10 peptides was 276 SFCs/106 PBMCs (interquartile range, 72-568/106 PBMCs), and the median of the incorporate SFCs was 612/106PBMCs (interquartile range, 192-1152/106 PBMCs). Conclusion T-SPOT.TB is highly sensitive in diagnosing extrapulmonary tuberculosis.

气体分子一氧化氮（NO）的发现开创了气体信号分子这一新型研究领域，目前已发现3种气体信号分子：NO、一氧化碳（CO）和硫化氢（H2S）。他们在体内内源性生成，发挥广泛的生物学效应，本文仅就3种气体信号分子在心血管系统中的意义进行简要阐述。在心血管系统中内源性气体信号分子NO、CO和H2S分别与其相应的合成酶一氧化氮合酶（NOS）、血红素加氧酶(HO)和胱硫醚-γ-裂解酶(CSE)形成独立而又相互关联的体系（NO/NOS体系、CO/HO体系、H2S/CSE体系），不仅参与心血管系统生理状态下功能和结构的维持，

ABSTRACT:Objective To analyze the baseline data of outpatient clinical subjects with vertigo and study on the clinical characteristics of vertigo. MethodThe questionnaires and clinical tests data of 3432 patients complained vertigo were retrospectively analyzed. Results All the patients received interview and vesti-bular function test. These patients aged 4-89 years with an average age of (40±18.6) years. Among of them 1513 (44.09%) were male and 1919 (55.91%) were female, with a male: female ratio of 1∶1.27. Vertigo patients increased according to age and reached its peak in the 41-60 years among all patients. The incidence might increase along with the increase of education level in urban populations. The onset of vertigo might correlate with the careers but differed among different populations. Conclusions Vertigo attacks patients in all age spans, but vertigo is highly prevalent in the population aged 41-60 years. The onset of vertigo is related to many different factors.

ObjectiveTo assess the value of dual energy computed tomography (DECT) for the detection of uric acid (UA) deposition in patients with gout. MethodsA total of 37 patients with tophaceous gout (including 8 crystal-proven cases) and 10 control patients (5 with unknown arthropathy, 3 with rheumatoid arthritis, and 2 with osteoarthritis) were included. DECT was performed for all peripheral joints (wrists, hands, elbows, knees, ankles and feet) . Color coding was used to display the localization of UA deposition. Images were reviewed independently by two trained radiologists. ResultsWith DECT, patients with gout were found to have UA deposits in hands and wrists 46% (17/37) , elbows 16% (6/37) , knees 27% (10/37) , ankles and feet 89% (33/37) . No UA deposit was observed in all 10 control patients (P=0.000) . Among the 37 patients with gout, the number of UA deposition sites detected by DECT (n=297) was 2.25 times of that detected by physical examinations (n=132) (P=0.000) . ConclusionsDECT allows the visualization of UA deposition in gouty arthropathy. Even subclinical disease can be delineated with this technique. However, the accuracy of DECT requires further investigations."

ABSTRACT:Objective To assess the left ventricular rotation and twist in patients with hypertrophic cardiomyopathy (HCM) by 2-dimensional ultrasound speckle-tracking imaging (STI). Methods Two-dimensional images of left ventricule（LV） at basal and apical short-axis views were acquired in 20 patients with HCM and 20 healthy subjects to evaluate LV rotation. LV twist were defined as rate of apical LV rotation to the basal. Peak rotation (Prot) and the time to Prot in basal and apical short axis views were measured separately. Peak twist (Ptw), twist at aortic valve closure (AVCtw), twist at mitral valve opening (MVOtw), untwisting rate (Untw R), and half time of untwisting (HTU) were calculated. Results Compared with the control group, the value of Prot-MV, Prot-AP, Ptw, time to Ptw, AVCtw, MVOtw, and HTU significantly increased (all P<0.05) and the Untw R significantly decreased (P<0.05) in the HCM group. In the HCM group, time to Prot in apical view was significantly higher than that in basal view. Conclusion STI can noninvasively evaluate the characteristics of LV twist and rotation in patients with HCM.

ABSTRACT:Objective To investigate the clinical characteristics of invasive pulmonary fungal infections(IPFI). Methods The clinical data of 48 patients with confirmed IPFI at Peking Union Medical College Hospital from January 2004 to December 2008 were retrospectively analyzed. Patients were divided into primary IPFI group and secondary IPFI groups based on their disease courses. Results The most commonly seen fungi were aspergillus species (37.5%) and cryptococcus species (37.5%), and community acquired infections accounted for 87.5%. The secondary IPFI accounted for 66.7% among all cases, in which the major pathogens were aspergillus species; in the primary IPFI group, the major pathogens were cryptococcus species. The symptoms of IPFI were non-specific and mostly presented as cough, fever, emptysis, and dyspnea. The common imaging features included multiple nodules, infiltrates and consolidations, or diffused lesions in bilateral lungs, and cavities were found in 11 patients (22.9%). The clinical symptoms and imaging findings were not significantly different between these two groups. A total of 46 patients (95.8%) received antifungal therapies or surgeries. Ten patients (20.8%; all from the secondary IPFI group) died, making the fatality rate significantly different between the primary IPFI group and secondary IPFI group (P=0.033). Conclusions The major pathogens of IPFI are aspergillus species and cryptococcus species, and most of them are community acquired. The secondary IPFI with aspergillus species tend to be highly fatal. The clinical symptoms and imaging features are non-specific. Early diagnosis with prompt antifungal therapies, or even with surgical intervention, may be beneficial for these patients.

ABSTRACT:Objective To investigate the role of endothelin-1 and its receptors on hypertrophy or proliferation of cultured cardial cells. Methods Cardiomyocytes and cardiac fibroblasts were isolated by trypsin digestion method, DNA and protein synthesis were measured by 3H-dexyribonucleotidethymine (3H-TdR) and 3H-Leucine (3H-Leu) incorporation, while protein content was measured by Bradford method. Atrial natriu- retic peptide (ANP)mRNA expression of cardiomyocyte was measured by reverse transcripted-polymerase chain reaction. Selective endothelin (ET) receptor subtype antagonists BQ123 and BQ788 were used to block ETA receptors(ETAR)and ETBR respectively and to observe the effects of the two receptors during cardiac hypertrophy. Results ET-1 significantly increased the3H-TdR and 3H-Leu incorporation rate of cardiomyocytes and cardiac fibroblasts in a dose-dependent manner and increased protein content. Furthermore, ET-1 promoted the ANP mRNA expression of cardiomyocyte. ETAR antagonist remarkably blocked these effects, while ETBR antagonist had no obvious effect. Conclusions ET-1 can induce the hypertrophy for cardiomyocytes and the proliferation for cardiac fibroblasts. These effects are mediated by ETAR.

ABSTRACT:Objective To observe the statuses of estrogen receptor（ER）α and β in the pelvic floor and its relation with stress urinary incontinence (SUI). Methods The ERα and ERβ in levator ani muscle and pelvic floor structure of premenopausal and postmenopausal SUI patients were detected by immunohistochemical staining and Western blot. Results The positive biopsy rates in the premenopausal and postmenopausal SUI groups were 11％ and 0, and the corresponding results in the control group were 35％ and 33％. No ERα and ERβ expression was detected in the levator ani muscle. ERα and ERβ located in pelvic fasia tissue around the levator ani muscle. ERβ was negatively stained in some segments of pelvic fasia tissue. The positive expression rates of ERβ in the pelvic fasia tissue of premenopausal and postmenopausal SUI group were 57％ and 33％, which were significantly lower than those in the control groups (P<0.05). The positive expression rate of ERβ in the pelvic fascia was significantly lower in postmenopausal group than in the premenopausal group（P<0.05）. The positive expression rates of ERα in the pelvic fasia tissue in the premenopausal and postmenopausal SUI groups were （4.43±2.64）％ and （5.14±1.79）％, which were significantly lower than （9.61±5.48）％ and （10.88±2.90）％ in control group (P<0.05). Western blot showed that ERβ expres-sion in pelvic fasia tissue was less than the expressions of ERα, ERα and ERβ in the SUI group was also lower than that of the control group. Conclusion ERα and ERβ do not express in the levator ani muscle of women. Pathogenesis of premenopausal SUI correlates with lower serum estrodiol level and the expression of ER correlates SUI.

ABSTRACT:Objective To evaluate the clinical outcome of a novel approach for pelvic floor reconstruction using synthetic mesh (modified total pelvic floor reconstruction) for treatment of pelvic organ prolapse. Methods Modified total pelvic floor reconstruction was performed in 30 patients with severe pelvic organ prolapse (including vault prolapse). The clinical outcome of each patient was assessed. Results The mean operation time was（74.2±21.5）minutes, and the mean blood loss was （103.3±40.1）ml. Among them, 23 patients (76.7%) were able to micturate spontaneously the next morning after surgery, with residual urine less than 100ml. The mean post-operative hospital stay was （4.2±1.8）days. All patients were followed up for a medium of 6 months. Totally 93.3% and 96.7% of patients were objectively (according to Pelvic Organ Prolapse Quantitive Examination score) and subjectively (according to Prolapse Quality of Life) cured, respectively. During follow-up, only one patient was found to have asymptomatic erosion, and de novo urgent urinary incontinence was seen in 6.7% of patients. The most prominent complication was dyspareunia (66.7%). Although the post-operative sexual function was reported to be worse, no significant difference between patients’ pre- and post-operative Pelvic Organ Prolapse/ Urinary Incontinence Sexual Function Questionnaire-12 scores was noted. Conclusion Modified total pelvic floor reconstruction is a safe, effective, and micro-invasive approach for severe pelvic organ prolapse repair; however, dyspareunia remains a main concern.

ABSTRACT: Gene chip technology, featured by large information capacity, easy performance, and rapid response, has became a research hotspot in recent years. Along with the further research in molecular biology and genomics, a large number of gene chip technologies have been developed and applied. This article describes the history, status quo, and future trends of gene chip technology.

目的 探讨肾功能不全患者发生造影剂肾病(CIN)的危险因素、临床特点及预后。方法 回顾分析北京协和医院住院诊断肾功能不全并接受冠状动脉造影的患者44例，其中造影后发生CIN 23例，未发生CIN 21例，比较两组患者的临床特点、造影日用药情况、造影剂使用剂量、造影前后的肾功能变化；根据造影后２周内血肌酐（Scr）水平是否下降至造影前水平，将发生CIN患者分为肾功能恢复组（12例）和肾功能未恢复组（11例），比较两组患者临床特点、造影日用药情况、造影前肾功能、造影剂使用剂量、造影日出入量。结果 所有肾功

ABSTRACT:Objective To observe the patterns of benign and malignant breast lesions using real-time gray-scale contrast-enhanced ultrasound and assess its value in the differential diagnosis of begign and malignant breast tumors. Methods Totally 116 breast lesions (benignity n=63; malignancy n=53) underwent real-time gray-scale contrast-enhanced ultrasound. The patterns of their enhancement were assessed from 6 aspects： degree of enhancement, process of enhancement, completeness of enhancement, homogeneity of enhancement, boundary of the enhanced lesions, and exhistance of radial enhancement around the lesions. The results were compared with the pathologic findings. Results Contrast-enhanced sonographic patterns were significantly different between benign and malignant breast lesions. Most malignant lesions were non-centripetally, incompletely, and inhomogeneously enhanced. After having been injected with the microbubble contrast medium, the boundary of the lesions became unclear, and the radial enhancement around lesion were mainly seen in the malignant lesions. Conclusion The patterns of real-time gray-scale contrast-enhanced ultrasound are remarkably different between malignant and benign breast lesions, showing promising values for its clinical application.

Objective To compare the ultrasound imaging characteristics of benign and malignant thyroid nodules on the background of Hashimoto’s thyroiditis(HT). Methods Totally 120 consecutive patients with pathologically confirmed benign(n=60)or malignant(n=60)thyroid nodules in Peking Union Medical College Hospital since January 2013 were retrospectively analyzed,and their preoperative ultrasound images were reviewed. Results Sixty cases(100%)of the malignant nodules were papillary thyroid cancers. In the benign group,33 cases(55.0%)had nodular changes of HT,26(43.3%)had nodular goiter,and one(16.7%)had adenoma. Compared with the benign ones,the malignant nodules were more likely to be solid(91.7% vs. 68.3%,P=0.001),hypoechoic(96.7% vs. 48.3%,P=0.000),ill defined(95.0% vs. 41.7%,P=0.000),irregular(96.7% vs. 43.4%,P=0.000),and more easily to have such characteristics as micro-calcification(71.7% vs. 30.0%,P=0.000),absence of regular halo(96.7% vs. 65.0%,P=0.000),taller-than-wide sign(46.7% vs. 13.3%,P=0.000),and locally increased or irregular blood flow(61.7% vs. 26.7%,P=0.000). Conclusions Ultrasound has an ideal overall sensitivity in differentiating nodules on the background of HT. Solid structure,hypo-echogenicity,ill-defined margin,irregular shape,and absence of regular halo are good screening ultrasound markers. Except for the A/T≥1,the other variables have less satisfactory diagnostic specificity.

ABSTRACT:Objective To study the value of prenatal ultrasound in the diagnosis of fetal malformations. Methods We retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006. Results The incidence rate of fetal malformation was 22.5‰ in our study group. The detection rate of prenatal ultrasound was 79.02%(1 062/1 344), among which the detection rate of the severe malformations (87.58%,860/982) were significantly higher than that of the minor malformations (55.80%,202/362)（P<0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities. Conclusion Prenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.