OBJECTIVE To improve the level of HBV-DNA quantity dection.METHODS The necessity and feasibility of quality control improvement on the basis of external quality assessment results were analyzed.The source of error were songht through analyzing the whole experiment process,to improv the experiment protocol.RESULTS Four main sources of error were improved,and two of them existed in reality.Through improvements in handling protocol,coefficient of variability(CV) of internal quality control has decreased to 3.3% from 9.3% before improvement in protocol.External quality control results were also increased in large-scale.CONCLUSIONS Through the improvement in experiment process,quality assurance of HBV-DNA quantity analysis has been upgraded in essence.

Objective To analyze the levels of serum total bilirubin in patients and healthy con-trols, eatablish a method of using the mean of total bilirubin in serum of patients to control internal quality, and validate the reference range. Methods Frequencies mode of SPSS13.0 statistic software package was applied to performing analysis of all data, and then the analytic interval was determined based on the frequencies of the data. The daily data mean in the analytic interval was calculated. With the daily data mean as the testing data, the quality control was carried out by the same way of quality control for quality control sample. At the end of each month, the means of various analyzers were compared. Based on the results of healthy controls, the formula mean±1.96s was used to validate the current reference range. Results With the daily data mean as the testing data for quality control, its coefficient variation was within the accepatable limit, and the 95% distribition range was the same as the current reference interval. Conclusion It is necessary to establish suitable interval in which the da-ta mean was used for internal quality control. The current reference range in our hospital is proper.

Objective To evaluate the diagnostic value of magnetic resonance urography(MRU)in patients with iatrogenic ureteral injuries.Methods MRU in 12 patients with iatrogenic ureteral injuries caused by gynecological and rectal operation were performed.Results MRU examinations were successfully done in all cases at once.The accurate rate in localized and qualitative diagnosis was all 100%.The injures of ureter in 12 cases were all located at lower segment of the ureter,of them,8 patients were purely obstruction,4 cases were obstruction with urinal leakage,all cases were accompanied by dilations of ureter and hydronephrosis.Conclusion MRU is helpful for the diagnosis of iatrogenic ureteral injury.

Objective To evaluate the effect of 3-dimmentional conformal radiotherapy (3-DCRT) for mediastinal metastasis from esophageal carcinoma after surgery.Methods Sixty-three such patients were treated by 3-DCRT. Tumor diameter was: cm 20 patients. Positive supraclavicular lymph node was found in 9 patients. The number of tumor at the upper right, upper left and upper median mediastinum was 27, 27 and 20. All patients received 3-DCRT to the dose of 40?Gy (2?Gy/f, 5f/w), after resetting of portals, the dose was boost to 64～70?Gy by 3?Gy/f, 5f/w. Dose of the patients who had been irradiated was boosted to 50?Gy without further positioning. Results Complete response rate and partial response rate were 43% and 48% one month after the treatment was concluded,with no progression of disease. The 1-, 2- and 3-year survival rates were 75%, 43% and 15%. Conclusions Three-dimmentional conformal radiotherapy, with little side-effects, can markedly improve the local control rate and suvival rate of patients with mediastinal metastasis from esophageal carcinoma after surgery.

Objective: To observe an abnormal expression of humoral immune response induced by memory B cells in tonsils and peripheral blood of patients with IgA nephropathy ( IgAN) , the variation of memory B cells after tonsillectomy , and to discover the role of tonsillectomy in IgAN .Methods: In the study , 28 patients were diagnosed as IgAN via renal biopsy , and 27 patients suffering from chronic ton-sillitis without nephritis and 10 normal human beings were selected as controls .The expression of memory B cells in the tonsils and peripheral blood was tested by flow cytometry , and the same method was used to test the variation of the expression of memory B cells in peripheral blood of patients with IgAN after tonsil -lectomy.Results:In this study , higher percentages of memory B cells were observed in tonsil and pe-ripheral blood of IgAN patients, which were 5.72%±5.26%, 4.92%±5.10%.After tonsillectomy, the percentage of memory B cells was 1 .10%±0 .65%, lower than that before tonsillectomy ( P <0.05).Meanwhile, in tonsils and peripheral blood , the percentage of memory B cells varied with the variation of the urinary findings of the IgAN patients .Conclusion:The percentage of memory B cell in tonsils and peripheral blood could predict disease progression of IgAN to a certain extent .

Objective To study the continuous drainage treatment by percutaneous puncture of Splenic Abscess (SA), which is due to double-embolization for treatment of liver cancer with hypersplenism. Methods 158 patients with liver cancer with hypersplenism were adopted as the subjects, of which, 7 ones were complicated with SA. Results The symptoms of the 7 ones were all alleviated, such as fever, abdominal pain, left interior pain. Conclusion Continuous drainage treatment by percutaneous puncture, combined with flushing abscess cavity by antibiotics solution, is very effective for SA due to double-embolization.

Objective To evaluate the feasibility , toxicity and clinical efficacy of intensity-modulated radiotherapy using the simultaneous integrated boost (SIB- IMRT) and concurrent chemotherapy for advanced nasopharyngeal carcinoma. Methods Thirty nsopharyngeal carcinoma were treated with full course IMRT including nasopharynx and full neck to supraclavicle. The radiotherapy dosage is 68 Gy to the target. Concurrent chemotherapy was given, and the regimen was DDP 40 mg/m2/weekly.Results The mean dose of covering gross tumor volume(PGTV) (D95) in the nasopharynx was 70.48 Gy, and the mean volume of PGTV1 receiving the 95 % dose(V95) was 98. 46 %. The mean dose of PGTV1, PGTV2, PCTV1 and PCTV2 in the targets were 70.8 Gy, 66.4 Gy, 62.3 Gy and 54.8 Gy. According to the evaluation, the acute skin,mucositis and salivary toxicity with grade Ⅲ in those patients were 3.3 %, 10 %, 6.6 %. The patients developed different blood toxicity, but didn't affect their treatment. The median follow-up time was 6.5 months, and disease free survival rate was 100 %. Conclusion SIB-IMRT yields well dose distribution and acceptable toxicity in advanced stage nasopharyngeal carcinoma. The preliminary clinical result is encouraging.

Objective To investigate the value of three-dimensional visualization system in the treatment of hilar cholangiocarcinoma.Methods The clinical data of 10 patients with hilar cholangiocarcinoma who were admitted to Chenggong Hospital of Xiamen University from January 2012 to September 2012 were retrospectively analyzed.The two-dimensional computed tomography images were converted to three-dimensional images with the three-dimensional visualization system,and then the volume of liver and tumor size,volume of liver to be resected,remnant liver volume were measured.Surgical procedure was planned based on the three-dimensional images,and the difference between the actual and planned surgical procedures was analyzed.The correlation between actual liver resection volume and predicted liver resection volume was analyzed by calculating the Pearson correlation coefficient.Results The mean liver volume,tumor size,predicted liver resection volume and remnant liver volume of the 10 patients detected by the three-dimensional visualization system were (1496 ± 162) ml,(67 ± 18) ml,(335 ± 241)ml and (1140 ± 197)ml,respectively.The average error rate of predicted liver resection volume was 6.4％.Surgical plan was made in accordance with the principle of curative hepatectomy,including 4 cases of left semihepatectomy,2 cases of right semihepatectomy,3 cases of partial liver resection and 1 case of palliative liver resection.The coincidence rate between the planned and actual surgical procedures was 9/10.R0 resection was performed on 7 patients,R1 resection on 1 patient and palliative resection on 2 patients.One patient received restrictive portal vein arterialization.Preoperative evaluation of the anatomy of blood vessels,bile ducts and tumors based on three-dimensional images was confirmed with operative findings.The accuracy of tumor typing by the three-dimensional visualization system was 8/10.The actual liver resection volume was (325 ± 258) ml,which was positively correlated with the predicted liver resection volume (r =0.902,P ＜ 0.05).Conclusion The three-dimensional visualization system is helpful in the treatment of hilar cholangiocarcinoma.

Objective To analyze the significance of postoperative radiotherapy for lymph node positive patients after radical resection of esophageal carcinoma.Methods Two hundred and sixty patients with esophageal squamous cell cancer,aged ≤70,with the performance status score of0 -1,who had undergone radical resection were divided into 2 equal groups:surgery alone group (Group A ) and surgery plus radiotherapy group (Group B).Group A was classified into 3 sub-groups:Group A1 (n =42)without lymph node involvement,Group A2 (n =43 ) with 1 to 3 involved lymph nodes,and Group A3(n =45) with ≥4 involved lymph nodes.Group B was classified into 3 sub-groups:Group B1 (n =43 )without lymph node involvement,Group B2 (n =44) with 1 to 3 involved lymph nodes,and Group B3(n =43 ) with ≥4 involved lymph nodes.The patients were followed up till death.Results The 1-,3-,and 5-year overall survival rates of Group A were 71.5％,35.4％ and 20％,respectively,all significantly lower than those in Group B (76.2％,48.5％ and 36.2％,respectively,x2 =7.822,P ＜0.05).The 1-,3-,and 5-year survival rates of Groups A1 were 83.3％,52.3％,and 38.1％,respectively,all not significantly different from those of Group B1 (81.3％,58.1％,and 46.5％,respectively,x2 =0.283,P ＞ 0.05 ).The 1-,3-,and 5-year survival rates of Groups A2 were 69.8％,34.9％,and 18.6％,respectively,all significantly lower than those of Group B2 (77.3％,47.7％,and 40.9％,respectively,x2 =4.188,P ＜ 0.05).The 1-,3-,and 5-year survival rates of Groups A3 were 62.2％,20％,and 4.4％,respectively,all significantly lower than those of Group B3 ( 69.8％,39.5％,and 20.9％,respectively,x2 =6.168,P ＜ 0.05).The 5-year metastatic lymph node rates of Groups A1 to A3 were 30.9％,53.4％,and 66.7％,respectively,all significantly higher than those of Groups B1 to B3 ( 11.6％,22.7％,and 30.2％,respectively,x2 =4.753,8.741,and 11.682,respectively,all P ＜0.05).The 5-year distant metastasis rates of Groups A1 to A3 were 11.9％,20.9％,and 31.1％,respectively,all not significantly different from those of Groups B1 to B3 (13.9％,20.4％,and 25.6％,respectively,x2 =0.079,0.003,and 0.203,respectively,all P ＞ 0.05 ).Conclusions Postoperative radiotherapy increases the survival rate of lymph node positive patients,but shows little efficacy on the lymph node negative patients.It reduces the occurrence of lymph node metastasis,even in the lymph node negative patients,and does not increase the morbidity of complications,especially that of anastomotic stenosis.The number of metastatic lymph node is one of the important factors affecting the survival of esophageal carcinoma.Distant metastasis increases along with the number of metastatic lymph nodes.

Objective To explore clinical features,prognosis and study related cancer types in patients with familial gastric carcinoma. Methods Nine families of ICG-HGC and 3 families of suspected-ICG-HGC according with International Collaborative Group on Hereditary Gastric Cancer standard were collected and their pedigree trees were drawn.Clincial features and prognosis of ICG-HGC and suspected-ICG-HGC families were analyzed.and the related cancer types of ICG-HGC and suspected-ICG-HGC kindreds were investigated. Resuits The morbidity of ICG-HGC and suspected-ICG-HGC was 0.99%;The age of patients among the propositi of 12 kindreds were 29～65 years old with the mean age of 56 years old.Among 11 kindreds,there were 45 cases of cancers including 2 cases of multiple cancers.There were 30 foci of gastric cancer,most of which were located in lower and middle third of the stomach,with pathologic type of adenocarcinoma in poor to moderate differentiation.There were totally 15 extrastomach tumors including 7 colorectal cancers.Four cases of 11 kindreds had survived for 3 years including 1 case surviving for more than 10 years. Conclusion The familial gastric cancers in southern China have special characteristics such as poorly pathologic differentiation,advanced cancer stage,early age of onset,distal end of the stomach in location and high incidence of related tumors in colorectum.