PurposeRecurrence limits the survival of postoperative hepatocellular carcinoma (HCC) patients. The purpose of this study is to investigate the value of ultrasound (US), CT and MRI follow-up in alpha fetoprotein (AFP) negative HCC patients.Materials and MethodsThe follow-up data of 31 pathology-confirmed, AFP negative HCC patients were analyzed retrospectively. All patients underwent US, CT and MRI. Features including tumor size, morphology, echogenicity and enhancement pattern were analyzed. The recurrent lesion detection rates of all three diagnostic modalities were compared.ResultsThere were 55 recurrent lesions. On CT and MRI, these lesions were round or ovoid in shape with long axis of 0.7-3.4 (1.7±1.1) cm. There were 16 solitary lesions and multifocal lesions in 15 cases. US showed widely distributed blood vessels within the lesions and heterogeneous flow rate. CT and MRI demonstrated significant enhancement in the arterial phase with wash out in portal phase and delayed phase. The detection rate were 60.0% (33/55), 83.6% (46/55), 89.1% (49/55) for US, CT and MRI, respectively (χ2=15.120,P<0.01). Detection rate of MRI (80.0%, 16/20) was signiifcantly higher than that of CT (65.0%, 13/20) and US (40.0%, 8/20) for lesions with long axis diameter of 0.7-1.0 cm (χ2=6.910,P<0.05). For lesions between 1.0-2.0 cm, MRI, CT and US detection rate were 91.7% (22/24), 91.7% (22/24) and 66.7% (16/24), respectively (χ2=6.792,P<0.05). ConclusionImaging follow up can detect AFP negative HCC recurrence. MRI has unique advantage in lesions <2 cm.

Objective To evaluate the clinical efficacy and safety of the cefazedone sodium in treatment of respiratory tract bacterial infections. Methods Single-blind randomized control trial was performed to evaluate the efficacy and safety of cefazedone sodium in treatment of respiratory tract bacterial infections, and cefazolin sodium as the controlled one. Patients in trial group (using cefazedone sodium, 35 patients) and control group (using cefazolin sodium, 37 patients) were all intravenously administered at the same doses of 2 g, every 12 hours for 5 to 14 days. A total of 72 patients were enrolled in the studies, 34 in trial group and 32 in control group, with 1 excluded and 5 withdrawn. Safety assessment was conducted in 71 patients. Results In trial group and control group, the total cure rates for respiratory tract infections were 91.18% (31/34) and 78.12%(25/32), and the general bacterial eradication rates were 80.00% (20/25) and 84.00% (21/25). The adverse drug reaction rates were 22.86 %(8/35) and 16.67% (6/36),there was no significant difference (P > 0.05 ). Conclusion Cefazedone sodium is a safe and effective antibiotic in the treatment of acute respiratory tract bacterial infections.

AIM: To investigate the pharmacokinetic properties and bioequivalence of nifedipine sustained-release tablets after multiple doses administration in healthy volunteers. METHODS: Twenty two male healthy volunteers were enrolled in a randomized two-way crossover design with multiple doses (20 mg·d-1×7 d) study. Nitrendipine was used as the internal standard and the concentrations of nifedipine in plasma were determined by HPLC-APCI-MS. The pharmacokinetic parameters were calculated and the bioequivalence were compared by DAS (ver 1.0) program. RESULTS: The pharmacokinetic parameters of test and reference preparations were as follows: Cmax (52.5±27.4) and (54.0±31.2) ng·ml-1;Cmin (5.4±4.1) and (6.2±5.9) ng·ml-1;Cav (16.8±9.2) and (19.3±12.4) ng·ml-1;Tmax (3.7±0.9) and (4.1±1.1) h;t1/2 (8.9±4.9) and (8.5±3.1) h;AUC0-τ (403.4±221.0) and (461.9±296.6) μg·h·L-1, AUC0-36h (444.4±256.1) and (503.1±330.9) ng·h·ml-1;AUC0-∞ (482.1±268.9) and (542.3±348.4) ng·h·ml-1;DF (299.8±117.7)% and (279.2±97.5)%, respectively. There were no significant differences (P>0.05) in Tmax, Cmax, Cmin, Cav, DF, AUC0-τ, AUC0-36h, AUC0-∞ and t1/2 between the two preparations. The relative bioavailability of test tablets was (100.6±38.6)%. CONCLUSION:The test and reference preparations were bioequivalence.

Objective Comparing the influence of neoadjuvant chemotherapy on sentinel lymph node biopsy and axillary lymph nodal staging. Methods From June 2005 to June 2007 one hundred and sixty five breast cancer patients of stage Ⅰ,Ⅱa,Ⅱb and Ⅲ underwent sentinel lymph node biopsy(SLNB) using 99mTc combining methylene blue dye as tracer to help axillary lymph node dissection(AND) were retrospectively reviewed. Sixty five patients staged Ⅱb or Ⅲ were treated with three circles neoadjuvant chemotherapy prior to SLNB and AND , another one hundred patients staged ⅠorⅡa had SLNB and AND directly without neoadjuvant chemotherapy.Results Average 14.60 axillary lymph nodes were retrieved in patients had neoadjuvant chemotherapy and 14.74 lymph nodes in patients did not have neoadjuvant chemotherapy(P>0.05),a mean number of 1.46 sentinel lymph nodes in neoadjuvant chemotherapy group and 1.5 sentinel lymph nodes in non-neoadjuvant chemotherapy(P>0.05), sentinel lymph node identification rate 96.9% in neoadjuvant chemotherapy group and 97% in non-neoadjuvant chemotherapy(P>0.05), the false negative rate was 4.6% in neoadjuvant chemotherapy group and 4% in non-neoadjuvant chemotherapy group(P>0.05). Conclusions The mean number of lymph nodes,sentinel lymph nodes,SLN identification rate and false-negative rates after neoadjuvant chemotherapy are similar to those seen in patients without neoadjuvant chemotherapy.The SLNB can accurately predict lymph node status of axillary lymph node following neoadjuvant chemotherapy.

Objective To detect levels of C?X?C chemokine receptor type 5 (CXCR5) and inducible costimulator(ICOS)in blister fluid of patients with bullous pemphigoid(BP), and to explore their significance in the pathogenesis of BP. Methods Blister fluid samples were collected from 15 patients with BP(experimental group)and 15 patients with second?degree burns(control group). Enzyme?linked immunosorbent assay(ELISA)was performed to detect the levels of CXCR5 and ICOS in the 2 groups. Results The level of CXCR5 was significantly higher in the experimental group than in the control group(219 ± 145.31 vs. 147 ± 23.83 ng/L, t=4.577, P<0.05), while no significant difference in the ICOS level was observed between the 2 groups (30.18 ± 14.86 vs. 21.43 ± 5.32 ng/L, t = 1.628, P > 0.05). Conclusion The expression of CXCR5 may be associated with the occurrence of BP, but further researches are needed to determine the relationship between ICOS and the occurrence of BP.

Objective The study was to investigate the spectrum and incidence of the hot-spot deafness gene mutations from non-syndromic hearing loss(NSHL)in Guizhou province.Methods Genomic DNAs of 356 patients of NSHI in Guizhou were obtained from peripheral blood and a deafness gene test chip was used to screen nine hot spot mutation in the gene GJB2,SLC26A4,GJB3 and mitochondria 12SrRNA.Results Eighty-eight (24.72%)out of 356 patients were found carrying at least one pathogenic gene mutation.Among them,40 patients with the GJB2 mutations were found(11.24%),including 19 cases(5.34%)of homozygous matutions,5 cases(1.40%)of com-pound heterozygous mutations,and 15 cases(4.21%)of single heterozygous mutations.Twenty-nine patients with the SLC26A4 mutations were found (8.15%),including 9 cases(2.53%)of homozygous mutations and 19 cases (5.34%)of single heterozygous mutations.Homogenic mitochondrial 12SrRNA 1555A>G mutations were in 10 patients(2.81%)and 1494C>T mutations in 10 patients (0.56%),and heterogeneous mitochondrial 12SrRNA 1555A>G mutations in 7 patients(1.97%).GJB3 gene c.538C>T heterozygous mutations was found in 1 patients. Conclusion The mutations of GJB2 and SLC26A4 gene are two major pathogenic genes for patients with NSHL in Guizhou province.Our study provides a theoretical basis for the early diagnosis,genetic counseling and treatment of deafness.

Objective This study aimed to investigate the incidence and the cause for duodenalbiliary reflux and reflux cholangitis after metallic stent placement in distal common bile duct Methods After percutaneous transhepatic bile duct puncture and biliary outside drainage was performed, 16 cases with malignant distal biliary stricture underwent metallic stent placement in distal common bile duct Before stent placement, the routine laboratory studies including leukocyte, neutrophil percentage and the levels of total bilirubin and direct bilirubin in blood were performed for all patients. Two to five days [ an average of (3.3 ±0. 9) days ] after stent implantation, the above indexes were tested again, and 1 ml of water containing 185 MBq of 99Tcm-DTPA was given orally before extubation, then 99Tcm radioactivity in the bile was detected 2 hours later. For the measurement data obtained from the experiment, t test or Wilcoxon signed rank test was adopted to compare them, and P ＜ 0. 05 was considered to be statistically different Results In 14 cases, radioactivity was successfully detected in the bile 2-5 days after stent implantation. Twelve of them was detected to have radioactivity in the bile 2 hours before extubation with duodenal-biliary reflux. The technetium count in the bile accounted for 1.82% of the total intake dose. There was no radioactivity in the bile in 2 cases. In 14 patients, there were no symptoms of cholangitis such as high fever, chills, increased jaundice, and so on after stent implantation. The mean of white blood cell count was (7.59 t2. 62) × 109/L, and the median of neutrophil percentage was 0. 74. Compared with those before stent implantation, the difference did not reach statistical significance ( t = 0. 423, Z = 1. 036, P ＞ 0. 05 ).After stent implantation, the median of total bilirubin and direct bilirubin were significantly lower, which were 92. 2 and 74. 3 μmol/L. Compared with those before stenting,the difference was statistically significant (Z= -3. 170, -3. 170, P ＜0.05). Conclusions There is a high incidence of duodenal-biliary reflux after stent implantation in distal common bile duct in the early stage. However, there is no simultaneous cholangitis caused by duodenal-biliary reflux.

Objective To observe the anti-influenza effect of a Chinese medicinal herb-Antiviral Agent No.1. Methods To study t he anti-viral effect of Antiviral Agent No.1 by means of the technique of cel l culture and using Ribavirin as a positive control. Results In MDC K cu lture, Antiviral Agent No.1 was found to be a potential inhibitor of influenza A 3 virus in a concentration-dependent manner, with a TC50 of 60.53 mg*m l-1. When drug was added 2 hours post virus infection, the EC50(TI) was 5.14 mg*ml-1(11.78); while drug was added 2 hours before infection, t he EC50(TI) was 5.20 mg*ml-1(11.65). Conclusions Antiv iral Agent No.1 had a significant anti-influenza effect on type A3 in MDCK.

Objective To evaluate the muscle mass in elderly patients with inguinal hernia using CT scan.Methods 30 male (age 70-90 years) hospitalized patients scheduled to receive surgery for inguinal hernia were selected into study group, 10 male health volunteers (40-50 years) were involved in adult control group, and 10 men of the same age as the study receiving annual physical examination were enrolled as elderly control group.General information were recorded;CT scanning of the stomach muscles and thigh muscles were conducted, and the muscle area was calculated using a special software.Results The index of grip strength in the study group was significantly lower than the adult control group [(36.44 ± 14.15) kg vs.(77.30 ± 22.69) kg, P =0.001], the calf circumference in the study group was significantly less than the adult control group [(25.18 ±2.31) cm vs.(27.62 ±2.33) cm, P =0.006].There was no significant difference in L3 abdominal area, subcutaneous fat area, abdominal fat area, and vertical spinal muscular volume between the study group and the adult control group;while the L3 abdominal muscle area and vertical spinal muscular mass was significantly less in the study group than in the adult control group [(12 094.23 ± 1 970.30) mm2 vs.(17462.00±1 600.58) mm2, P=0.001;(1 642.60±266.90) mm2 vs.(2 003.50±350.91) mm2,P =0.007].L3 skeletal muscle index of the study group was 50.64 ±7.52 and 66.7％ (20/30) of the study group had sarcopenia (≤52.4％).The CT findings of abdominal muscle of the study group were not significantly different from those of the elderly control group.The thigh muscle mass in the study group was significantly less than that in the control group (P =0.001), but there was no significant inter-group difference in thigh fat and femur areas (P ＞ 0.05).Conclusion The muscle mass and strength in elderly patients with inguinal hernia are significantly lower than those of adult controls, for which CT scan can be applied for assessment.

Objective To investigate the risk of falling and nutritional status in elderly surgical patients,and to assess the correlation between them.Methods Patients aged ≥65 in Department of General Surgery of Beijing Hospital between January and June 2015 were enrolled in this study.The Morse Fall Scale was used to evaluate the risk of falling.Anthropometrics,body composition,and Nutritional Risk Screening 2002 (NRS 2002) scores were collected to evaluate the nutritional status of the patients.The correlation between risk of falling and nutritional status was analyzed.Results A total of 383 patients were included,including 314 cases under 80 (65-79 years) and 69 cases ≥ 80.Patients ≥ 80 years showed significantly lower grip [(24.53 ± 8.09)kgvs.(30.57 ±8.48)kg,P＜0.05] and4-meter gait speed [(0.66 ±0.19)m/s vs.(0.84 ± 0.20) m/s,P ＜ 0.05],but significantly increased undemutrition [15.9％ (11/69) vs.7.0％ (22/314),P ＜ 0.05] and nutritional risk [56.5％ (39/69) vs.38.2％ (120/314),P ＜0.05].Altogether 33.9％ of the patients (130/383) were at high risk of falling,and the prevalence was significantly higher in patients ≥80 than in patients ＜ 80 [44.9％ (31/69) vs.31.5％ (99/314),P =0.036].Compared with patients not at high risk of falling,high-risk patients had lower body mass index [(22.33 ± 1.82) kg/m2 vs.(23.76 ± 3.26) kg/m2] and grip [(24.95 ± 8.56) kg vs.(30.72 ± 8.39) kg],but higher prevalence of nutritional risk [46.9％ (61/130) vs.38.7％ (98/253)] (all P＜0.05).Conclusions Eldedy surgical patients have a high risk of falling,which may be related with their nutritional status.Nursing and nutrition intervention should be emphasized in there patients to prevent falling and improve clinical outcome.