Objective To evaluate the clinical value of magnetic resonance cholangiopancreatogra-phy ( MRCP) and endoscopic retrograde cholangiopancreatography ( ERCP) in the diagnosis of obstructive jaundice. Methods MRCP and ERCP were performed in 32 patients with obstructive jaundice, all patients were diagnosed surgically or histopathologically. Results The level of obstruction was diagnosied by MRCP and ERCP with accuracy of 90.6% (29/32) and 82. 8% (24/29) respectively(P =0. 5960) ,whereas the accuracy of combination of MRCP and ERCP reached 96. 9% (31/32) . For the etiologic diagnosis, the accuracy reached 75.0% (24/32) and 72. 4% (21/29) in MRCP and ERCP respectively ( P = 0. 9503) , whereas the accuracy MRCP and ERCP of imcombination reached 93. 8% (30/32) , significantly higher than that of MRCP( P = 0.0387) or ERCP alone(P = 0. 0245). Conclusions MRCP and ERCP are reliable and safe methods for the diagnosis of obstructive jaundice; furthermore, combination of the two procedures could improve the efficacy of diagnosis.

Objective To observe the protective effect of Naoli Zhibao(NZ) on mice with learning and memory impairment.Methods (1) Thirty-two NIH mice were randomized into pseudo-operation group,model group,and low-and high-dose NZ groups(at the dose of 4 and 8 g?kg-1?d-1 respectively).Except the pseudo-operation group,the mice in other groups received the operation of cerebral ischemia/reperfusion.After treatment for 10 days,the learning and memory abilities of the mice were observed by step-down test,and the contents of malondialdehyde(MDA) and nitric oxide(NO) as well as the activities of superoxide dismustase(SOD) and glutathione peroxidase(GSH-Px) were detected.Meanwhile,the free amino acid content in mice cerebral cortex was measured with high performance liquid chromatography.(2) Forty NIH mice aged 9 months were randomized into normal control group,mimetic aging group,and low-and high-dose NZ groups(at the dose of 4 and 8 g?kg-1?d-1 respectively).The mice models of mimetic aging were induced by intraperitoneal injection of D-galactose 0.5mL for 6 weeks,and the mice in NZ groups were also given gastric gavage of NZ for 6 weeks.After treatment,the learning and memory abilities of the mice were observed by step-down test,and the contents of epinephrine(E),norepinephrine(NE) and tryptophan(TP) in mice cerebral cortex were measured.Results (1) NZ significantly improved the memory ability of mice with cerebral ischemia/reperfusion injury(P

Objective To study the reliability and validity of the Chinese version of the dynamic occupational therapy cognitive assessment for children (DOTCA-Ch).Methods The English version of the DOTCA-Ch was translated into Chinese. One hundred and nine students from the city of Jiamusi were assessed with the Chinese Binet intelligence test and the DOTCA-Ch. Intra-class correlation coefficients (ICCs) were used in inter-rater and intra-rater reliability assessments. Cronbach's alpha coefficient was used to assess internal consistency. Factor analysis was used to assess construct validity. Pearson correlation coefficients were used in assessing criterion-related validity. Results The total ICC of the DOTCA-Ch was 0. 892. Cronbach's alpha coefficients for the subtests were orientation 0. 713 ; spatial perception 0. 793 ; praxis 0. 850 ; visuomotor construction 0. 844 and thinking operations 0. 630. The ICC for intra-rater reliability was 0. 991 and for inter-rater reliability it was 0. 989. Using the Binet intelligence test as a benchmark, the Pearson correlation coefficient between the IQ values and the total DOTCA-Ch scores was 0. 872 for 6 year-olds, but 0. 870 for 11 and 12 yearolds. Factor analysis revealed an acceptable set of 5 common factors. Their cumulative contribution was 67％.Conclusions The Chinese version of the DOTCA-Ch is reliable and valid. It can be used as an effective measuring tool to evaluate children's cognitive functioning.

Objective To discuss the imaging findings and pathological features of primary pulmonary lymphoepithelioma-like carcinoma (LELC). Methods Imaging and pathological data of 13 patients (9 male and 4 female, age from 17 to 72 years, median age 52 years) with pathology-proven primary pulmonary LELC from January 2010 to March 2015 were retrospectively analyzed. Thirteen patients underwent X-ray examination, two of them underwent non-enhanced CT scan, eight underwent non-enhanced and enhanced CT scans, one underwent non-enhanced MR scan. All imaging data including location, number, shape, size and density of lesions were analyzed by two experienced chest radiologists respectively and reached an agreement after consultations. Surgery was performed in 11 cases and aspiration biopsy in 2 cases. HE staining was performed in all cases and immunohistochemistry staining in 6 cases. Results All thirteen primary pulmonary LELC were unilateral. Nine peripheral tumors and four central tumors were identified. Lobulations (n=11), spiculas (n=7), vessel convergences (n=3), vascular encasements (n=2), pleural indentations (n=4) and punctuate calcification sign (n=1) were seen in the CT images. Thirteen tumors had diameters ranging from 1.3—11.0 cm, average diameter of (4.4 ± 2.7) cm, and all showed homogeneous density in non-enhanced CT. CT value ranged from 22—48 HU, average value of(34± 10)HU, and during arterial phase it ranged from 33—70 HU, average value of(53 ± 13)HU;and during venous phase it ranged from 43—86 HU, average value of(66±14)HU;the tumor had long T1 and long T2 signal in non-enhanced MR scan, and signals were homogeneous. Pathologically, the tumor was from pleomorphic epithelial with large cells, syncytia in the infiltration of lymphocytes or accompanied with collagenzation. Large nucleus showed vacuole-shape. Immunochemistry CK(+), P63(+), CK5/6(+), CK14(-) supported the diagnosis of LELC. Conclusions There are certain imaging characteristics for primary pulmonary LELC. Histopathological and immunohistochemistry examination could provide the definitive diagnose.

Objective To study the correlation of multi-slice CT portography (MSCTP) and digestive endoscopy in the diagnosis and evaluation of esophageal and gastric varices (EGV) caused by cirrhosis.Methods A total of 92 patients with cirrhosis were enrolled in the prospective study.All the patients were examined by endoscopy and 64-slice spiral CT scan in 4 weeks.The types,grading of EGV were observed by endoscopy and MSCTP,and Kappa conformance test was applied with the endoscopic findings as gold standard.The sensitivity,specificity,consistency,and Youden index were evaluated for the diagnosis of sophageal and gastric varices by MSCTP.Results Sixty-five patients were diagnosed to have EGV by endoscopy and 27 were negative.The positive patients included 45 patients of GOV1,19 of GOV2 and 1 patient of IGV1.MSCTP diagnosed 67 cases of EGV and 25 patients of negative results.The positive patients included 46 of GOV1,18 of GOV2 and 3 of IGV1.Two patients of IGV1 varicose veins without positive findings on endoscopy were diagnosed by using MDCTP,which revealed isolated varicose veins under the gastric mucosa.There was high consistency between MSCTP and EGV in the diagnosis of EGV (Kappa =0.732,P ＜ 0.01).The sensitivity of MSCTP was 93.8％,specificity was 77.8％,consistency was 89.1％,and Youden index 71.6％.There was high consistency between MSCTP and EGV in the classification of EGV (Kappa values were 0.743 and 0.763,P ＜ 0.01).Conclusions There is high consistency between MSCTP and digestive endoscopic in the diagnosis and classification of EGV in cirrhosis.MSCTP is superior to endoscopy in the detection of gastric varices.

Objective MRI and MR hydrogen proton spectroscopy (1H-MRS) were used to detect the abnormal signal and alteration of metabolites, in order to explore the efficacy of these method in evaluating the damages of central nervous system (CNS) induced by occupational manganese exposure.Methods Eighteen workers exposed to manganese without any manganism symptoms, 12 workers with slightly chronic manganese poisoning, and 19 healthy workers were scanned using routine MRI sequence and 1H-MRS.The blood manganese concentration was also collected for each subject.On cerebral axial T1 WI,the signal intensities of ipsilateral globus pallidus and frontal white matter were measured in the visually brightest area (try to select the signal homogeneous region), and the globus pallidus index (PI) was then calculated.The 1H-MRS data was calculated to get the values of the peak height of N-acetylaspartate (NAA), choline (Cho), inositol (mI) and creatine (Cr) and the ratios of NAA/Cr, Cho/Cr, and mL/Cr were also calculated.One way ANOVA was used to compare the values of PI, NAA/Cr, Cho/Cr, mI/Cr and MnB among the three groups, and the correlations between PI and the time span of manganese exposure or blood manganese concentration were analyzed by Pearson correlation analysis.Eight workers exposed to manganese were followed up one year, and their PI , NAA/Cr before and after follow-up were compared by t test.Results Fourteen of 18 cases exposed to manganese without any manganism symptoms showed symmetrically high intensity signal on T1 WI, while the T2 WI were normal.No high signal intensity was observed on T1WI in any of the healthy workers or manganese poisoning workers.We found that the average PI in manganese exposed group (1.16 ±0.09) was significantly higher (F =24.79 ,P =0.O00)than those of the poisoning ( 1.05 ± 0.07 ) and control groups ( 1.01 ± 0.05 ).The blood manganese concentration in manganese exposed group, the poisoning group and the control group were (0.051 ±0.024), (0.047 ±0.018 ), ( 0.043 ± 0.020 ) μg/ml respectively, which was not significantly different ( F = O.623, P =0.541 ) and did not exceed the upper limit of normal reference value ( < 0.10 μg/ml ).There was a significantly correlation between PI and the time span of manganese exposure ( r = 0.67, P = 0.002 ),however, there was no correlation between PI and blood manganese concentration ( r = 0.20, P = 0.427 ).Furthermore, the NAA/Cr ratio decreased variously in the manganese poisoning group ( 1.22 ± 0.07 ) which was significantly lower( F = 4.120, P = 0.023 ) than those of the poisoning( 1.33 ± 0.13 ) and control groups ( 1.31 ±0.13).No statistical significanees were found in the ratios of Cho/Cr and mI/Cr among these three groups(P>0.05).No obvious changes of the PI and NAA/Cr were found in the 8 manganese exposed workers after 1 year follow-up.Conclusion Manganese exposure could lead to the high intensity signal on T1 WI, therefore the increased PI may be the biomarkers of central nerve system damages caused by the occupational manganese exposure.

ObjectiveTo investigate the consistency between the results of passive particle agglutination test ( PPA ) and ELISA on Mycoplasma pneumonia ( M.pneumonia ) infection.Study the diagnostic value of both assays.Methods From November 2010 to May 2011,the serum samples of ]191 patients with respiratorysymptoms were collected fromAffiliatedHospitalof JiningMedical University.All samples were tested for antibody levels against M.pneumonia using PPA,and for IgM,IgG,IgA subclass using ELISA.The correlation between the results of two methods was evaluated by Kappa test and Spearman rank correlation analysis.The variances of the antibody subclasses among samples with different PPA titers and different age groups were analyzed by Kruskal-Wallis test.The infection status of patients was analyzed based on ELISA results and the clinical relevance of both assays was evaluated in comparison with clinical diagnosis for samples with high PPA titer.ResultsThe level of agreement between the results of PPA and ELISA was 84.3％,with Kappa value of 0.642 ( P ＜0.01 ).The prevalence of IgM and IgA antibody against M.pneumonia was significantly different among samples with various PPA titers ( P ＜0.05 ).The prevalence of IgM subclass was higher in chill and teeuager groups,while that of IgA and IgG were higher in elderly group.Antibody isotyping results suggested that 58.1％ of PPA positive samples (75 cases),especially 96.4％ of samples with high PPA titer ( 27 cases),were of current infection,which was in consistent with clinical diagnosis.ConclusionPPA showed good consistency with ELISA on diagnosis of Mycoplasma pneumonia infection.Antibody subclass determination hy ELISA indicates disease progression,thus to differentiate current infection from past.

Objective To investigate the relationship between CT signs of portal hypertension and histopathologic stage of chronic hepatic fibrosis and cirrhosis. Methods Tri-stage enhance volume CT scan of upper abdomen was performed in 84 participants, including 48 patients with hepatic fibrosis confirmed by liver pathologic biopsy which divided into S1 (12/48), S2 (14/48), S3 (9/48) and S4 (13/48),16 patients with typical cirrhosis, and 20 healthy subjects as a control group. Measured the caliber of left and right branch of portal vein, MPV, SV and SMV at MIP images respectively, observed the collateral circulation, ascites and the size of spleen and then studied comparatively these measured parameters of different histopathologic stage. One-Way ANOVA was performed in the comparison of the vascular diameter of portal system and the size of spleen(SNK was used in the comparison between the groups). x2 test ofR × Ctable was performed in the comparison of ascites and collateral circulation among groups, and the vessel of portal system which has the greatest impact on the pathological staging of hepatic fibrosis was investigated with Logistic regression analysis. Results The caliber of left branch of portal vein, right branch of portal vein. MPV. SV and SMV were (0.98±0.11). (1.00±0.12), (1.33±0.11). (0.75±0.10).(1.07±0. 12) em respctively, the size of spleen was (128. 55±30. 56) cm<'3>, and collateral circulation and ascites were not found in control group. SV enlarged gradually in test groups and showed S1 (0. 86±0. 12) cm, S2(0. 96±0. 11) cm, S3(1.07±0.08) cm, S4(1.09±0. 10) cm, typical cirrhosis (1.18±0. 19) cm respotively. The difference between each group of S1 to typical cirrhosis and control group was significant, and the same result was seen among S3 to S4, cirrhosis and S1 to S2. Logostic regression analysis showed that the standardized regression coefficient of SV was maximum (2. 719) and had statistical significance(P <0. 01). The incidence of collateral circulati on and ascites in patients with typical cirrhosiswas significant higher than that of normal liver and every stage of hepatic fibrosis (P < 0. 05). Conclusion CT scan may be helpful for the early detection of advanced hepatic fibrosis or early stage of liver cirrhosis for patients with chronic liver disease.

Objective]To explore the aberrant expression of SOD1 gene in nasopharyngeal carcinoma tissues and adjacent tissues,as well as in NPC cell lines,then to observe the effect of SOD1 on NPC cells metastatic ability and investigate the intrinsic?mechanism.[Methods]Immunohistochemical technique was used to examine SOD1 expression in carcinoma tissues and adjacent tissues(n=10). Small interfering RNAs and inhibitor LCS-1 were used to knockdown of SOD1 expression and inhibit SOD1 activity, respectively. Then,wound healing test and migration assay were applied to detect cell metastatic ability in vitro. Real-time PCR and Western Blot were used to analyze the expression of EMT-related genes(E-cadherin,Vimentin,Twist).[Results]SOD1 was found to be significantly up-regulated in nasopharyngeal carcinoma tissues(n = 7 ,70%),compared to control. SOD1 was also highly expressed in highly metastatic potential NPC cell lines(CNE2,5-8F,S18)compared with low metastatic ability cell lines(6-10B). Knockdown SOD1 expression or inhibit SOD1 activity suppress cell motility in CNE2 and 5-8F cells. Finally,we demonstrate that SOD1 inhibition plays a role in induction of epithelial marker E-cadherin and has an opposite effect on mesenchymal marker vimen tin and transcriptional factor twist.[Conclusion]These results suggest that SOD1 contributes to EMT and might be important for tumor metastasis in NPC.

Objective To explore the methods and results of the application of formative assessment in gynecology and obstetrics nursing teaching.Methods In the gynecology and obstetrics nursing teaching practice,556 undergraduate students in Grade 2011 were set as experimental group while 339 students in Grade 2010 as control group.Based on the teaching syllabus,in the experimental group,traditional lecture and bilingual teaching method were applied in theory courses and PBL or PBL combined with Scene simulation were applied in practice lessons.And after the teaching,formative assessment was applied in the experimental group,which included setting up small study groups and learning files,giving evaluation to students' participation in class activities,written assignments,operation exams,attendance to classes and their in-class test results.In the evaluation of a student,the results of formative assessment took a proportion of 50％ and the final exam result took the other half.While in the control group,traditional summative assessment was applied,namely,results of the final exams were the terminal results of students.Results Gynecology and obstetrics nursing got the first prize in the Final-term Assessment of Teaching Efficiency of the Nursing School.When comparing the results of the final exam of the students in the experimental group and the control group,there was statistically difference(P=0.000),and 86％ of the students in the experimental group were in favor of formative assessment.Conclusion When applied in gynecology and obstetrics nursing teaching in undergraduate students,formative assessment can help teachers adjust teaching methods to improve the effectiveness of teaching; it can also make students more motivated in learning and help students form good learning habits and improve their learning strategies,which can improve students' comprehensive quality.