Gadolinium ethoxybenzyl dimeglumine (Gd-EOB-DTPA),a newly applicable hepatocyte-specific contrast agent,can provide both dynamic and hepatobiliary images and has been rapidly accepted by clinicians for the diagnosis of liver lesions and preoperative evaluation.Gd-EOB-DTPA can fulfill hepatic perfusion imaging,detection and characterization of focal liver lesions,evaluation of liver function,and predict biological behaviors of hepatocellular carcinoma (HCC) within the same examination in a relatively short time window.A large number of domestic and foreign studies have confirmed that hepatobiliaryspecific enhanced magnetic resonance imaging (MRI) was significantly superior to MRI scan,enhanced CT and ultrasound in diagnosing HCC.With the help of the advanced imaging techniques,surgeons can accurately diagnose and assess the situation of patients to implement individualized treatment plans,and therefore these will promote the development of precision hepatic surgery.

Objective To investigate the predialysis education on dialysis timing of patients with end-stage renal disease (ESRD). Methods 129 patients with chronic renal failure (CRF) and serum creatinine(Scr)＞442μmol/L, endogenous creatinine clearance rate (Ccr)＜20 ml/min were randomly divided into the experimental group(70 cases) and the control group(59 cases), the experimental group received predialysis education, the control group received routine care.The basic situation, dialysis timing, depression and quality of life on the 6th,12th months after dialysis were assessed. Results There was no significant difference in age, sex, education background, health care payment manners, employment, serum creatinine, endogenous creatinine clearance rate before education.For the timing of dialysis, Ccr for the experimental group was (9.49 ± 0.77)ml/min, Ccr for the control group was (4.54 ±1.79) ml/min,the difference was significant, depression and quality of life between two groups after 6,12 months of dialysis was also statistically different. Conclusions Strengthening predialysis education is conducive to a timely start of dialysis and can effectively improve the quality of life in patients with ESRD.

Objective To investigate the changes of serum adiponectin level and insulin resistance in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods 80 adult habitual snorers were divided into mild,moderate,severe OSAHS groups and control group,based on their apnea hypopnea index (AHI).Correlative clinical data were measured and analyzed.Results Serum adiponectin level [( 5.44 ± 2.57 ) mg/L] was significantly lower and HOMA-insulin resistance index ( 3.42 ± 0.70) was significantly higher in severe group than other groups ( P ＜ 0.05 ).Serum adiponectin level was negatively correlated with BMI,waist hip ratio,neck circumferences and et al( r =-0.233 ～ -0.499,P ＜0.05),but it was positively correlated with lowest oxygen saturation ( LSaO2 ),Ⅲ + Ⅳ％ and REM％ ( r =0.270～ 0.429,P ＜ 0.05).Conclusions Both hypoadiponectinemia and insulin resistance were observed in severe OSAHS patients.The related risk factors of hypoadiponectinemia in OSAHS might include obesity,disordered sleep architecture and other adipokines.

OBJECTIVE:To evaluate therapeutic efficacy and safety of ubenimex combined with chemotherapy in the treatment of malignant tumor,and to provide evidence-based reference in clinic.METHODS:Retrieved from Central,PubMed,CJFD,VIP and Wanfang database,randomized controlled trials (RCTs) about ubenimex combined with chemotherapy (trial group) vs.single chemotherapy (control group) in the treatment of malignant tumor were collected.The quality of studies were evaluated by bias risk evaluation criteria of Cochrane system evaluator manual 5.1.0 after screening literatures and extracting data.Meta-analysis was performed by using Rev Man 5.3 statistical software.RESULTS:A total of 12 RCTs were included,involving 762 patients.The resuits of Meta-analysis showed that:shorter-term response rate [RR=1.24,95 ％ CI (1.08,1.43),P=0.002] and the improvement rate of life quality Karnofsky score [RR=1.69,95％ CI(1.46,1.95),P＜0.001] in trial group were significantly higher than control group;the incidence of gastrointestinal toxicity [RR=0.74,95％CI(0.57,0.94),P=0.02] and leucocyte suppression rate[Ⅰ °-Ⅳ°(＜3 months):RR=0.54,95％CI(0.37,0.79),P=0.002;Ⅲ°-Ⅳ°:RR=0.44,95％CI(0.29,0.68),P＜0.001] were significantly lower than control group,with statistical significance.CONCLUSIONS:Ubenimex combined with chemotherapy can improve malignant tumor,shorter-term efficacy and life quality,and reduce gastrointestinal and marrow toxicity.

Objective To determine whether neuron?specific enolase(NSE)affects the prognosis of extensive small cell lung cancer by analyz?ing the association between NSE before treatment and disease progression and overall survival of patients. Methods This study retrospectively an?alyzed 83 inpatients in the medical oncology department of the First Affiliated Hospital of China Medical University from March 2008 to September 2014. The Kaplan?Meier method and Cox proportional hazards models were used to analyze relevant factors affecting the prognosis of extensive small cell lung cancer;statistical significance was determined for a P value less than 0.05. Results The lactate dehydrogenase(LDH)level be?fore treatment was significantly associated with the progression?free survival(PFS)(P=0.001)and overall survival(OS)(P=0.036). The NSE level before treatment was also significantly associated with the PFS(P=0.007)and OS(P=0.013). Conclusion LDH and NSE affect progno?sis and survival of patients with extensive small cell lung cancer.

ObjectiveTo screen out the two-component system associated with drug resistance of Mycobacterium tuberculosis by detecting the differential expression of two-component system regulator genes between multidrug resistant Mycobacterium tuberculosis strains and drug sensitive strains. MethodsTotal RNA of MTB was extracted from cultured MTB during the logarithmic phase in the 7H9 brook medium, and then its purity was identified. Reverse transcription was further completed. The expressing levels of TCS response regulators were quantified using SYBR Green I qRT-PCR, which aimed at finding the differential expressions between multidrug resistant strains and sensitive strains. Finally, all of differentially expressed TCS were screened out under the stress of INH, SM and LFA. Results Compared with sensitive strains,multidrug resistant strains of Rv0491, Rv3133c, Rv3143 and Rv3246c were up-regulated 1. 03, 7.11,3.48and 1.37 folds, respectively (t/t' =5. 623, -4. 196, -3. 559 and -3. 016, respectively, P ＜0. 01 ). The expressing level of other regulators had no statistical significance between muhidrug resistant strains and drug sensitive strains. Under the antibiotic pressure, the expression of Rv1027c, Rv3246c and Rv3143 showed significant changes compared with no antibiotic group. ConclusionRv3246c and Rv3143 may be associated with MTB drug resistance and the differentially expressed genes in multi-drug resistant strains may be used as potential drug targets against drug resistant tuberculosis.

Objective To explore the factors that affect the prognosis of extensive small cell lung cancer by analyzing the association between lab-oratory indicators before treatment of extensive small cell lung cancer patients and the initial evaluation results with disease progression and overall survival. Methods This study retrospectively analyzed 96 cases of hospitalized patients in the medical oncology department of The First Hospital of China Medical University from March 2008 to September 2014. Kaplan-Meier method and Cox proportional hazards models were adopted to ana-lyze the relevant factors affecting the prognosis of extensive small cell lung cancer. P<0.05 was considered statistically significant. Results There was no obvious correlation between HB level before treatment with PFS of patients(P=0.179),but there was obvious significant correlation be-tween HB level and OS of patients(P=0.041). Our results showed that the TBIL level of patients before chemotherapy was significantly associated with the PFS(P=0.039)and OS(P=0.026)of patients. Conclusion HB and TBIL levels are the influencing factors that affect the prognosis and survival of patients with extensive small cell lung cancer.

Objective To study the characteristics of antimicrobial resistance and molecular epidemiology of Staphylococcus aureus (S .aureus)in the intensive care units(ICUs)of a hospital.Methods Clinical isolates of S .aureus collected from ICUs between January and December 2014 were identified and performed antimicrobial susceptibility testing,then typed by staphylococcal protein A (spa)typing and multilocus sequence typing (MLST) methods.Results Of 160 isolates of S .aureus ,120 (75.00%)were methicillin-resistant S .aureus (MRSA). Resistance rates of MRSA to erythromycin,clindamycin,and levofloxacin were all > 80%;methicillin-sensitive S .aureus (MSSA)were sensitive to cefazolin,resistance rates to erythromycin,clindamycin,and levofloxacin were 62.50%,35.00%,and 10.00% respectively.spa typing and MLST results showed that the main types of 120 isolates of MRSA were ST239-t030,ST239-t037,and ST5-t2460,the major epidemic strains were ST239-t030 (n=105,87.50%),and were isolated from 8 ICUs;MSSA had more types,ST59-t437 were detected only from depart-ment of neurology(n =8)and department of digestive diseases(n =2),ST6-t701 ,ST398-t3625,ST398-t1793,and ST121-t2092 were isolated from departments of neurology(n=7),anesthesiology(n=5),neurosurgery(n=4),and cardiac surgery(n=4)respectively.Conclusion Isolation rate of MRSA in ICUs in this hospital is high,ST239-t030 is the main type,which prevailed in hospital;different types of MSSA have epidemic trends in various departments.

Objective To express recombinant HBHAΔC and HBHAΔN protein,and compare the HBHA series protein activity with each other.It will be provide a experimental basis for the research on clinical diagnostic of HBHA.Methods The HBHAΔC and HBHAΔN gene fragments were cloned and expressed by transforming E.coli BL-21.Test the protein heparin binding ability by CL-6B column.And then added protein to the BCG 7H9 culture medium,to observe the induced BCG aggregation.Results nHB-HA,rHBHA and HBHAΔN protein have heparin binding ability.Meanwhile nHBHA,rHBHA and HBHA Δ C protein have in-duced BCG aggregation effect.Conclusion The HBHAΔC and HBHAΔN protein were successfully obtained.It was proved that the HBHA C-terminal could be combined with heparin and the N-terminal involved could induce the aggregation of BCG.This results provide a basis for further study on molecular mechanism of TB infection and clinical application.

Objective To purify native and recombinant heparin-binding hemagglutinin(HBHA)protein,and investigate the activity of HBHA polyclonal antibody against aggregation of Bacillus CalmetteGuerin(BCG)induced by HBHA.Methods After growing BCG to the stationary phase in the 7H9 liquid medium,the native HBHA protein(nHBHA)was obtained by CL-6B column chromatography.At the same time,the HBHA gene fragment was cloned and expressed by transforming Escherichia coli BL-21.Then the polyclonal antibody against rHBHA was prepared by immunizing rabbit.Different comcentration of the HBHA protein was added to the BCG liquid medium,and the aggregation of the BCG was observed.Then,add the HBHA protein that incubated with anti-HBHA antibodies to the BCG culture medium and observe the aggregation of BCG.Results The purity of native HBHA was 99% and the concentration was 1.016 mg/ml.The expressed product contained 36% of total somtic protein.After purified,the purity of the recombinant HBHA protein was 97.1% and the concentration was 10.98 mg/ml.Both the rHBHA and nHBHA could induce the aggregation of BCG.When then concentration of nHBHA is 0.2μg/ml,BCG could be induced to aggregate,while the rHBHA concentration is 2μg/ml could induce the aggregation.Both aggregations could be suppressed by the polyclonal antibody against rHBHA.Conclusions The native and recombinant HBHA are successfully obtained.It is proved that the rHBHA could induce the aggregation of BCG similar as nHBHA,and polyclonal antibody against rHBHA could also suppress the activity of nHBHA.It suggested that rHBHA could be further used in clinical diagnosis and vaccination.