Sixty-four patients with solitary pulmonary nodules were included in this study. The diameter of pulmonary nodules was equal or less than 3.0 cm and no contact with the adjacent pleura. They were divided into study group( with acuductor locating method)and conventional group (with conventional method). The results showed that the one-time success rates were 97％ (31/32)in study group and 72％(23/32) in conventional group, the diagnostic accuracy were 94％ ( 30/32 ) and 88 ％ ( 28/32 ), respectively,while the successful puncture time were( 13. 5 ±4. 9)min and( 18. 7 ±5. 7) min, respectively. In study group,the complication rate was 9％ (3/32), while 28％ ( 9/32 ) in conventional group. There were statistical differences between the two groups. CT-guided aspriation biopsy for solitary pulmonary nodules with self-made acuductor can obviously improve one-time success rate and reduce the complication rate and operative time.

Objective To investigate the association of single nucleotide polymorphisms (SNPs) of loci rs4570625,rs11178997 at promoter region of tryptophan hydroxylase 2 (TPH2) genes with alcohol dependence and depressive symptom in the alcohol-dependent subjects in north Chinese Han people.Methods Genotype and allele frequencies of the TPH2 rs4570625 and rs1 1178997 polymorphisms were examined in 60 alcohol-dependent subjects (patient group) and 62 normal controls (control group) by Polymerase Chain Reaction (PCR) amplification and DNA sequencing techniques.The alcohol-dependent subjects were evaluated by 24 Hamilton Depression Scale (HAMD).Association analysis was carried out between the polymorphism and symptom of depression in the alcohol-dependent subjects.Results There were significantly statistical differences in the rs4570625 alleles (G and T) (x2 =5.280,P＜0.05),but no statistically significant differences in the genotypes (G/G,G/T,T/T) (x2 =5.078,P＞0.05) between patient group and control group.Significant statistically difference could be found in the rs4570625 alleles (G and T) between the alcohol-dependent subjects who had depressive symptoms and the subjects who did not have depressive symptoms (P＜0.05),but no significantly statistical differences could be found in the genotypes frequency (P＞0.05).No significant statistically differences in the genotype and allele frequencies of the rs 11178997 were observed between the alcohol-dependent subjects and normal controls and the alcohol-dependent subjects who had depressive symptoms and the subjects who did not have depressive symptoms (all P＞0.05).Conclusion The results suggest that the liability of alcohol dependence and depressive symptoms in alcohol-dependent subjects may be associated with the polymorphisms of TPH2 rs4570625 in north Chinese Han population,and the variant of the T allele may contribute to the morbidity.However,the polymorphisms of TPH2 rs1 1178997 may have no association with the susceptibility of alcohol dependence and the depressive symptoms accompanied with alcohol dependence.

Objective To investigate melanocyte membrane antigen associated with vitiligo,for further purification and cloning.Methods Sera from patients with vitiligo were screened by using a live cell enzyme-linked immunoabsorbent assay,98strongly positive sera were obtrained.Melanocyte antigens were immunoblotted after splitting of cultured normal human melanocytes.Thirty strong positive vitiligo sera were detected.Results There were positive bands in all screened sera as shown by immunoblotting.Whereas,positive band was seen in only one normal human sera.The antibody bound many antigens with different molecular weights(150kd,90kd,75kd,50kd,40~45kd).Positive rates for individual antigens were70%,60%,83%,16%and23%,respectively.Conclusions Antibody directed to melanocyte membrane antigens of melanocytes are present in the sera of patients with vitiligo.The molecular weights of the antigens are mainly150kd,90kd and75kd,the antigens with small molecules discovered previously maybe the degradation products of big molecules.

Objective To observe serum sCD40L,MMP9 levels and their relevance with different types of coronary heart disease(CHD).Methods The present study was involved in 90 patients with CHD,including acute myocardial infarction(AMI)30 case,unstable angina pectoris(UAP)31 case,stable angina pectoris (SAP)29 case and another 25 normal controls.The serum MMP9 and sCD40L levels were detected with enzyme-linked immunosor-bent assay.Results The levels of MMP9,sCD40L in AMI and UAP group were significantly higher than those in SAP group[(69.48 ±4.76)ng/mL,(66.61 ±5.30)ng/mL,(30.44 ±7.66)ng/mL,t=1.425,0.075,all P<0.05], there were no statistically significant differences in the serum MMP9,sCD40L levels between AMI group with UAP group (all P>0.05 ),and also there were no ststitically signiticant differeces in the serum MMP9,sCD40L levels between SAP group with control group (all P>0.05).MMP9 level in AMI and UAP group was positively related with sCD40L (r=0.96,P<0.01 and r=0.97,P<0.01 ).Conclusion The serum sCD40L and MMP9 levels of acute coronary syndrome(ACS)increase significantly,and can be used as an important index to assess the severity of CAD and predict the instability of plaque in CAD patients.

Objective To observe the changes of ischemia modified albumin (IMA),high -sensitivity C -reactive protein (hs -CRP)after percutaneous coronary intervention (PCI).The factors related to intervention procedures to patients with IMA and hs -CRP elevation after PCI and impact of the risk of IMA and hs -CRP on the clinical outcomes were investigated.Methods IMA,hs -CRP from vein blood of 90 cases received PCI were detec-ted before operation and after operation at time of 30 min,2h,6h and 24h.The clinical characteristics of patients and factors related to intervention procedures were recorded.The number of lesion vessels and the relative factors in PCI were compared.The clinical outcomes of the patients were followed up.Results After operation,IMA was significantly different compared with that before operation (t =2.293,P <0.05).The concentration of IMA peaked at 2h after operation,which was significantly different from that before surgery (t =1.116,P <0.01).The increase of IMA and hs -CRP were closely related with the inflation pressure,total times of inflation,dilated times,length and diameter of stent and the number of stents (t =3.678,P <0.01 ).The angina onset was more common and length of stay was longer in the patients with the rise of IMA and hs -CRP.Conclusion PCI may cause myocardial injury,which is associated to inflation pressure,total time of inflation,dilated times,length and diameter of stent and the number of stents.To a certain extent the level of troponin can predict the outcomes.

Human papillomavirus-related diseases are worldwide,what more,they may progress into benign or malignant tumors.On the other hand,through antinomy analytical method,scientists have modified E6 and E7 dialectically and make them the core of the HPV therapeutic vaccine, which can speedup the clean out of the virus.

Evidence-based medicine(EBM)is an inevitable development tendency of clinical medicine education in 21 century.Its core thinking is to combine evidence,personal experiences and patients'actual situation.The thinking of EBM will magnificently promote the conversion of conception and model of clinical education and will make significant influence on clinical teaching,scientific research and clinical practice.

Objective To study the variable number tandem repeats(VNTR)polymorphism in intron 4 of the endothelial nitric oxide synthase(eNos)gene and its relationship with plasma NO in patents with PAH of COPD.Methods The VNTR polymorphism in intron 4of the eNos genes of PAH COPD and healthy control were detected by PCR.The plasma level of NO3-/NO2-was measured by spectrophotometer,which was used as an index of NO synthesis.Data were analyzed according to the different genotype and allelic gene frequency.Results The COPD PAH group significant higher frequency of VNTR 4a allele and 4a/4b allele and 4a/4b+4a/4a genotype than those of the control(P=0.027,P

Objective To investigate the supplementary roles of MRI in the diagnosis of fetal abnormalities in twin fetuses.Methods MRI manifestations of 22 twins were retrospectively analyzed after abnormalities were found by prenatal ultrasonography (US) from Sep 2005 to Dec 2012.Two rapid scanning sequences were used in the study,fast-imaging employing steady-state acquisition (FIESTA) and fast inversion recovery motion insensitive (FIRM).MRI findings were compared with those of prenatal US,induced labour or postpartum diagnosis.Results A total of 22 twins were reported with 23 abnormal fetuses in 20 twins and 2 normal twins.MRI confirmed central nervous system abnormalities in 3 abnormal fetuses which were anencephalus,meningoencephalocele and enlargement of lateral ventricles respectively.The case of meningoencephalocele was showed brain tissue protruding from the occipital defect on MRI,which was misdiagnosed as a cystic lymphagioma by US.The MRI diagnosis of anencephalus and enlarged lateral ventricles were accordant with US.MRI made the definite diagnosis in 5 chest abnormalities,which were left congenital diaphragmatic hernia (CDH) in 5 abnormal fetuses.They were diagnosed as possible CDH by US.Abdominal abnormalities (n=7,8 abnormal fetuses) included two fetuses in one twin with expanded digestive tract,one fetus with expanded colon and rectus and five fetuses with omphalocele.MRI diagnosis was compatible with US diagnosis in the 7 cases.Twins micromelia were found in one case with 2 abnormal fetuses.Conjoined twins in chest and abdomen were found in another case,which manifested as two hearts,one shared liver and independent urinary tracts and gastrointestinal tracts on MRI.One fetus in twin was dead (n=1,1 abnormal fetus).MRI showed small size and skin edema of the dead fetus.One acephalus acardius of twins (n=2,2 abnormal fetuses) was proved.Normal MRI manifestations were indicated in 2 cases which were suspected by US for abnormal digestive tract and cryptorachischisis respectively.Conclusions MRI,an important supplementary method of prenatal US diagnosis,shows valuable advantages including multi-plane manifestations,more extensive visual field and good soft tissue contrast.It is especially helpful in the diagnosis and treatment of multiple pregnancy.

Objective To investigate the curative effect and safety of transcatheter arterial chemoembo -lization (TACE) containing raltitrexed scheme for primary hepatocellular carcinoma (PHCC).Methods From May 2013 to June 2014,a total of 90 patients with inoperable PHCC were treated with TACE containing raltitrexed scheme.The short-term effect,long-term effect and adverse reactions were analyzed.Results Of the 90 patients,complete response was obtained in 23,partial response in 36,stable disease in 24 and progressive disease in 7,the effective rate was 65.6％.The one-year survival rate was 72.2％,the median survival time was 15.9 months,and the progression free survival was 9.1 months.Single factor analysis showed that the statistically significant differences in survival rate existed among the patients with different BCLC staging,combination therapy,lipiodol deposit pattern and vascular tumor thrombus (P＜0.05).Multivariate analysis of Cox model indicated that BCLC staging (x2=9.83,P=0.002) and combined therapy (x2=6.40,P=0.011) were independent prognostic factors.The main adverse reactions were fever,pain,vomiting and bone marrow suppression.Grade Ⅲ-Ⅳ adverse reactions were rare and no treatment-related death occurred.Conclusion For the treatment of inoperable PHCC,TACE containing raltitrexed scheme is effective and safe,and this therapy can be well tolerated by patients.