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To investigate the clinical and genetic characteristics of patients with idiopathic hypogonadotropic hypogonadism (IHH), the clinical data of 23 patients with IHH were retrospectively analyzed. Gene analyses were accomplished with whole-exome sequencing (WES) and Sanger sequencing. Functional prediction of mutation sites was conducted using two bioinformatics platforms, SIFT and Polyphen. Among the 23 patients with IHH, 9 patients carried prokinin 2 (PROKR2) gene mutations including 4 missense mutations (p.W178S, p.Y113H, p.A103V, p.R164Q), and 1 frameshift mutation (p.D42delinsDED), the remaining 14 cases were found negative in gene sequencing. Functional prediction showed that the above mutations may affect protein function suggestive of a pathogenic role of PROKR2 mutation in the patients. There were no significant differences in the levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol between the IHH patients with PROKR2 gene mutation and those without. PROKR2 gene mutation might associated with IHH, and the mutations reported in the present study could enrich the pathogenic spectrum of genes.
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The 17α-hydroxylase/17, 20-lyase deficiency (17-OHD) is a rare disease. The clinical characteristics and gene mutation of 2 late-diagnosed 17-OHD patients with testicular tumor admitted to our hospital from March 2018 to February 2019 were analyzed retrospectively. The two 17-OHD patients were female (46, XY). Laparoscopic abdominal exploration found undeveloped testicles in grey-yellow or grey-red in the groin and iliac fossa. The testicles were removed and showed malignancy in pathology study. Sequencing of the CYP17A1 gene identified c.1247G>A/c.1427T>C and c.985_987delTACinsAA/c.1306G>A complex heterozygous mutations. Taking together, the possibility of 17-OHD should be considered in patients with hypertension, hypokalemia, adrenal adenomatoid hyperplasia together with 46, XY gonadal dysplasia, so as to make early diagnosis and treatment, and avoid dysplastic testicular turning to malignancy.
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Objective To investigate the clinical significance of HCV antibody S /CO values in active HCV infection diagnosis in cancer patients .Methods 390 cancer patients were enrolled from Cancer Hospital Chinese Academy of Medical Sciences between January 2013 and April 2015.All of the cancer patients had pathological diagnosis , including 240 males and 150 females, aged from 25 to 83 years old. HCV antibody and HCV RNA levels were detected using the Abbott i 2000 immunity analyzer and Roche LC480 real-time fluorescent quantitative PCR machine , respectively.The relationship between HCV antibody S/CO value and RNA level was analyzed in the group of HCC and non-HCC patients.Results There were obvious statistical differences in age (P＝0.004), gender (P＜0.001) and HCV antibody levels (P＜0.001) between the group of HCC and non-HCC patients.There was no statistical difference in distribution of RNA positive rate between the two groups (P＝0.528).Using ROC curve analysis, the best cut-off value to diagnose active HCV infection in cancer patients is 10.0 with sensitivity 97.6%and specificity 81.3%. According to the results of the ROC curve , the cut-off was 11.4 and 10.4 in HCC and non-HCC patients respectively.Conclusion The best cut-off value to diagnose active HCV infection in cancer patients is 10.0, either in HCC or in non-HCC.
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The National Health and Family Planning Commission of China together with State Administration of Traditional Chinese Medicine jointly issued Regulations on Cost Accounting for Public Hospitals at County Level in order to promote the comprehensive reforms of county level public hospitals and regulate cost accounting.The issu-ance of the Regulations provides operation guidance on cost accounting at county level public hospitals, specifies divi-sion of responsibility for cost accounting, lays out details of implementation, and emphasizes the importance of achie-ving cost accounting through the use of information technologies.The Regulations incorporates many impressive terms, forming the foundation for effective cost accounting at county level public hospitals.
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Financial departments of hospitals should widen their horizons .Workers responsible for financial affairs should transform their functions and make the transition from the traditional business accountants to the value managers.The idea of macro financeis proposed in this paper to penetrate the financial ideas into every economic and business activity, every element of the workflows and every member of the staff .In practice, fine management of hospitals can be done jointly by using information platforms , employing financial management tools and organizing ef-ficient financial teams .By doing this , both financial management and operation efficiency of hospitals can be im -proved continuously .
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Objective: From the two prospective of hospital quantity and hospital market shares, to analyze the influences of profitmaking hospital’s competition on medical expenses and medical quality. Methods: The sample of provincial panel data from 2003 to 2011 is used, the fixed effect model is applied. Conclusion: For the competitive effect, the expanding of relative scale of profit-making hospitals increased outpatient expenses and reduced hospitalization expenses; for the quality effectiveness, the expand of relative scale of profit -hospitals improved the quality of outpatient service; the simple increase of the quantity of profit -making hospitals had no significant influences on medical expenses and quality of medical care.
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Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.
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@#ObjectiveTo observe behavioral changes and the dynamic expression of cyclooxygenase-1(COX-1) in the spinal cord of rats after unilateral sciatic cryoneurolysis(SCN).Methods72 male SD rats were randomly divided into 3 groups: normal control group(N, n=6), sham group(S, n=33) and cryoneurolysis group(C, n=33). The mechanical withdrawal threshold and autotomy assession were assessed before and 1, 2, 4 weeks after operation and COX-1 immunohistochemistry was performed on L4-6 spinal cord in 6 rats.ResultsFollowing SCN, rats exhibited significant bilateral tactile hypersensitivity until 4 weeks after operation. Furthermore, we observed autotomy peaked in severity and incidence (in 40% of rats, 1 weeks and 43.8%, 2 weeks ) 1 to 2 weeks after SCN. The COX-1 expression in dorsal horn of the spinal cord in group C was significantly higher than group S 2 and 4 weeks after operation (P<0.05).ConclusionCOX-1 plays an important role in spinal cord pain processing and central sensitization after SCN.
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Objective To investigate the clinical value of tissue polypeptide specific antigen(TPS),neuron-specific enolase(NSE),carcinoembryonie antigen(CEA)and CA125 in serum of small cell lung cancer(SCLC)patients and its significance in diagnosis and disease monitoring.Methods Serum leveh of TPS was detected using ELISA and serum levels of NSE,CA125 and CEA was detected using ECLin 27 1 SCLC patients.80 pulmonary benign disease patients and 224 normal healthy people.Diagnostic values of these tumor markers were analyzed by receiver operative characteristic(ROC)curve.Results The levels of TPS,NSE,CA125 and CEA iu the serum of SCLC group were signifieanfly higher than those in pulmonary benign disease and healthy group(Z＞1.90,P＜0.01).The levels of TPS and NSE in the serum of extensive stage small cell lung cancer(ESCLC)patients were significantly higher than those in limited stage small cell lung cancer(LSCLC)(Z=2.69,2.27,P=0.009,0.02 respectively).,The level of TPS and NSE showed statistical significance among SCLC patients with different prognosis after therapy(Z=4.06,3.11.P=0.001,0.007 respectively).The TPS+NSE showed the highest sensitivity of 86.7%,and the specificity,PPV and NPV were 75.0%,81.0% and 82.2%,respectively.Conclusions Serum levels of TPS,NSE,CA125 and CEA are useful for SCLC diagnosis.TPS+NSE shows the highest clinical values in SCLC diagnosis and prognosis.