Objective To evaluate the clinical value of serum high density lipoprotein cholesterol (HDL-C)in the evaluation of synthetic function of the patients with liver diseases.Methods Abbott Aeroset automatic biochemical analyzer was used to detect serum HDL-C level in control group (30 cases) and liver disease group(87 cases).T test was used to analyze the differences of serum HDL-C level in liver disease group and control group,different liver disease groups and control group,and different liver disease groups.Results HDL-C level was (1.28 ±0.20)mmol/L in the control group,(0.77 ± 0.15)mmol/L in the liver disease group,and (0.81 ± 0.13)mmol/L in the hepatitis group,(0.68 ± 0.14)mmol/L in the liver cirrhosis group,(0.54 ± 0.05)mmol/L in the liver cancer group.The HDL-C level in liver disease group and hepatitis group,liver cirrhosis group,liver cancer group was significantly lower than that in the control group(t =15.5569,14.2463,45.4393,25.6344,all P ＜ 0.01).The HDL-C level in liver cirrhosis group and liver cancer group was significantly lower than that in hepatitis group (t =3.6583,16.9057,all P ＜ 0.01).The HDL-C level in liver cancer group was significantly lower than that in liver cirrhosis group(t =4.4103,P ＜ 0.01).Conclusion Serum HDL-C level can be used to evaluate synthetic function of the liver,the lower of serum HDL-C level,the more serious liver synthesis function is impaired.

Objective To study the abdominal perineal resection for rectal cancer and clinical application of pelvic floor recon-struction .Methods 30 cases of rectal cancer patients from 2008-2011 were randomly divided into experimental group and the con-trol group ,30 cases in each group .Experimental group patients by columnar abdominal perineal resection of rectal cancer treatment , postoperative pelvic floor defect for dermal matrix reconstruction .The control group patients for colorectal cancer resection by lapa-rotomy .Results Compared with the traditional open resection ,the operation time ,intraoperative blood loss ,postoperative patholog-ical column T3 N0 M0 positive rate ,incidence of complications and incision aspect of cylindrical abdominal perineal resection were ob-vious advantages ,the difference was statistically significant (P< 0 .05) .Conclusion Compared with Miles surgery ,cylindrical ab-dominal perineal resection for rectal cancer can reduce the incidence of postoperative incisal edge positive rate and bowel perfora -tion .Human decellularized dermal matrix basin redevelopment can significantly reduce the surgical risk and difficulty of surgical op-erations .

Objective To establish the sensitive,specific,stable and convenient immunoradio assay for detecting human soluble IL-6R?.Methods The hybridoma cell lines were obtained by fusing spleen cells of BALB/c mice that had been immunized with soluble IL-6R? protein to mouse myeloma cells sp2/0. Ascites were used to produce the monoclonal antibodies (mAbs). The mAbs were purified by protein G immunoaffinity method. The mAb SI10 was used as coating antibody, the other mAb H126 recognized different epitope from SI10 was labeled by 125I. Results The immunoradio assay for detecting soluble IL-6R? was set up. It has high stability and accuracy. The detecting limit is 10 ng/ml. The serum concentration of soluble IL-6R? is (81.96 ? 7.23) ng/ml in healthy donors and (237.58?70.96) ng/ml in patients with multiple myeloma. Significant difference was founded between two groups (P

Objective:This study aimed to determine the function of herbs in preventing diarrhea after irinotecan chemotherapy and analyze the efficacy of the herbs based on UGT1A1*28 gene polymorphism. Methods:A total of 200 patients admitted to the De-partment of Synergistic Chinese and Western Medicine, Tianjin Medical University Cancer Institute and Hospital between October 2011 and May 2013 were randomly divided into the control (chemotherapy alone) and herb (chemotherapy combined with herbs) groups. All patients consented to UGT1A1*28 gene polymorphism detection prior to chemotherapy. Herbs were administered from 2 d prior to chemotherapy to 5 d post chemotherapy, with or without the regimen of fluorouracil, folinic acid, and irinotecan. Adverse reac-tions were recorded, and short-term effect was evaluated regularly. Results:A total of 144 patients had TA6/6 wild genotype, and anoth-er 56 patients had non-wild genotype (12 of the 56 cases were TA7/7 homozygous, and the other 44 cases were TA6/7 hybrid). A total of 58 patients experienced grades 2 to 4 diarrhea. A 14%decrease in the incidence of diarrhea was observed in the herb group compared with that of the control group (22%vs. 36%, P=0.029). In addition to diarrhea, grades 2 to 4 vomiting was significantly lower in the herb group than in the control group (15% vs. 27%, P=0.037). The overall response rate was 37.5%. No significant difference was found between the two groups (40% vs. 35%, P=0.465). The incidences of grades 2 to 4 diarrhea (22.9% vs. 44.6%, P=0.002) and grades 2 to 4 vomiting (23.2%vs. 16.7%, P=0.016) were lower in patients with the UGT1A1*28 wild genotype than in those with the non-wild genotype. However, in the herb group, the incidences of grades 2 to 4 diarrhea (22.2% vs. 21.9%, P=0.974) and vomiting (18.5% vs. 13.7%, P=0.777) were not significant between the non-wild-and wild-type groups. Conclusion:Herbs can effectively pre-vent the late diarrhea caused by irinotecan, which is also applicable in UGT1A1*28 non-wild genotype patients. Incidence of diarrhea was obviously higher in the cases with UGT1A1*28 non-wild type than in those with wild genotype. Hence, the UGT1A1*28 gene type should be detected prior to chemotherapy with irinotecan.

Objective To explore the influence factors of hidden blood loss during the treatment of femoral intertrochanteric fractures with percutaneous compression plate( PCCP) in elder patient. Methods The data of 136 patients with intertrochanteric fracture in our hos-pital from March 2009 to March 2012 treated with percutaneous compression plate were retrospectively analyzed,the effect of age,fracture type,preoperative aspirin,internal diseases on perioperative hidden blood loss, and different haemoglobin ( HGB) levels in patients with dif-ferent distribution were analyzed. Results The mean hidden blood loss volume was 499 mL,which accounted for 92. 54% of the total blood loss. The mean HGB decline was 11 g/L. The rate of on admisson haemoglobin level lower than 80 g/L was 6. 62% in AO type A2. 3 and A3 groups,and the rate of postoperative haemoglobin level lower than 80 g/L was 14. 70%. The average hidden blood loss for AO type A2. 3 (862 mL) and A3 (698 mL) were higher than those for AO types A1 (430 mL),A2. 1 (450 mL) and A2. 2 (415 mL) (P<0. 05). Multi-variate linear regression analysis showed that comminuted fracture and preoperative aspirin treatment were independently associated with in-creased perioperative hidden blood loss. Conclusion It indicated that the overt blood loss was fewer for PCCP operation. Intertrochanteric fracture was the main reason for substantial perioperative hidden blood loss. Types A2. 3 and A3 intertrochanteric fracture were early predic-tive factors of postoperative haemoglobin level lower than 80 g/L in elderly patients.

Objective To explore the CT characteristics of mucinous cystadenocarcinoma of appendix.Methods The CT findings of 5 patients with mucinous cystadenocarcinoma of appendix proved by surgery and pathology were analyzed retrospectively,and the corresponding literatures were also reviewed.Results All lesions in 5 patients showed cystic changes in the right hypogastrium inclu-ding irregular shape with lobulation in 4 and tubular shape in 1.The maximum traverse diameters ranged from 27 mm to 146 mm. Unclear boundary was showed if the lesion invaded the adjacent gut.The cystic wall was asymmetry and thickened with little nodes and nipple in the inner wall.The thick septa were seen in 3 tumors.Much mucus was seen in tumors with uneven density and average CT value of 1 9.3 HU-34.6 HU.On enhanced CT,obvious enhancement of the cystic wall and septa in 4 and moderate enhance-ment in 1 was showed.The adjacent fatty gap of 3 tumors were clear,however it was vague when accompanied with acute inflamma-tion.Small calcification in 3 and enlarged lymphatic nodes in 3 were also found.Conclusion CT shows some characteristics of mu-cinous cystadenocarcinoma of appendix and plays an important role in the diagnosis of the disease.

The article explores the teaching content in immunology according to "three modules and one line" and tamps the knowledge points of the basic module ,forms the point-into-line methods of the core module and emphasizes the application of extending module to expand the teachin "gspaces" between the theachers and students.

ObjectiveTo evaluate the clinical results of minimally invasive ankle arthrodesis with percutaneous cannulated screws.MethodsBetween April 2005 and October 2010, 12 patients with the ankle arthrodesis for unilateral severe arthritis (Kellgren-Lawrence class Ⅲ) were prospectively analyzed, including 2 cases of rheumatoid arthritis, 8 cases of post-traumatic arthritis, and 2 cases of osteoarthritis. There were 7 males and 5 females with an average age of 42.0 years(range, 25-7 1). The average disease duration was 7.3 years (range, 1-21). The anterior median incision of 3.0-5.0 cm was made to explore the ankle joint.The cartilage of tibial-talus joint was completely debrided. Two guide pins were inserted from posterosuperior to anteroinferior, and cannulated screws were implanted to fix ankle joint. All patients were physically examined with an extended protocol of questionnaires and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Scales. Ankle fusion in all patients was evaluated by clinical examination, and conventional radiography including anterior-posterior, lateral and mortise views of the ankle. ResultsAll 12 patients were followed up postoperatively for an average of 21.5 months(range, 6-55), and were proved be bone union by clinical examination and radiology with a mean of 13.5 weeks (range, 9-21). The AOFAS rating scale improved from a mean of 42.8±8.6 points at pre-operation to a mean of 66.6±5.4 points at post-operation 6 months,showing significant difference(t=-3.075, P=O.012), and to a mean of 72.3±4.6 at the final follow-up, also showing significant difference with pre-operation (t=-8.595, P=-0.006). There was no infection,local skin necrosis, screw loosing, and so on. ConclusionThe minimally invasive ankle arthrodesis with percutaneous cannulated scews is a recommend procedure, with mini-invasion, short surgery time, high fusion rate, good clinical outcomes, few complications.

Objective To observe the osteogenic effect of tissue-engineered bone constructed by poly-L-lysine-demineralized bone matrix (PLL-DBM) enriched bone marrow stem cells in the space of goat transverse process bone fusion model and explore a new tissue-engineered bone construction method. Methods PLL was used to decorate goat DBM to prepare a matrix material (PLL-DBM). The osteo-genic effect of tissue-engineered bone constructed by PLL-DBM enriched bone marrow cells ( Group Ⅰ A) was detected in goat lumbar intertransverse graft bone model; autogenous iliac bone (Group Ⅰ B), DBM enriched bone marrow (Group Ⅱ C) and DBM (Group Ⅱ D) were used as controls. The osteogenesis of the bones in the fused segments of four groups were compared and evaluated by X-ray, three-dimensional CT, CT value testing and biomechanical testing. Results The results of X-ray showed that the fusion ranges in groups ⅠA and ⅠB were basically the same, which were significantly wider than that in Group Ⅱ, with no fusion detected in Group Ⅱ D. The CT value was (696.76±10275) HU in Group Ⅰ A and (766.03±69.24) HU in Group B, which were significantly higher than that in Group Ⅱ C (P <0.05), but there was no statistical difference in CT value between Groups Ⅰ A and Ⅰ B (P > 0.05). The CT val-ue in Group Ⅱ C was significantly higher than in Group ⅡD (P <0.01). There was no statistical differ-ence between Groups Ⅰ A and Ⅰ B in the maximum load and bending strength (P > 0.05). The maxi-mum load and bending strength in Groups Ⅰ A and Ⅰ B were significantly higher than that in Group Ⅱ C (P < 0.05), and the two indices in Group Ⅱ C were significantly higher than that in Group Ⅱ D (P <0.01). Conclusion Tissue-engineered bone constructed by PLL-DBM enriched bone marrow cells is an ideal tissue engineered bone and its osteogenic potential is similar to that of autologous bone.

Objective To evaluate the bone healing effect of vascularized tissue-engineered bone induced by endothelial progenitor cells(EPCs)in repair of large segmental radius defects in rabbits.Methods A total of 68 healthy New Zealand white rabbits were enrolled in the study and randomized into three groups,ie,experimental group(EPCs group):EPCs plus bone marrow mesenchymal stem cells (BMSCs)plus decalcified bone matrix(DBM);control group:BMSCs plus DBM;sham control group:pure DBM.Materials mentioned above were implanted into middle radius defects for 15 mm.At 12 and 16 weeks post-operatively,X-ray test,bone mineral density test,histological light microscopic test,osteocalcin immunohistochemical staining test and biomechanical test were carried out.Results Growth and plasticity of callus,speed of medullary cavity recanalization,bone healing speed and biomechanical intensity in the experimental group were all significantly better than those of control group.Conclusions Vascularized tissue-engineered bone induced by EPCs has strong osteegenic ability,can accelerate bone healing and hence is an effective method for repair of large segmental bone defects.