Objective To evaluate the differential diagnostic values of combined detection of adenosine de aminase (ADA),carcinoembryonic antigen (CEA),carbohydrate antigen 153 (CA153),neuron-specific enolase (NSE) and carbohydrate antigen 199 (CA199) in patients with pleural effusion.Methods Serum and hydrothorax fluid of CEA,CA153,NSE and CA199 in patients with plearal effusion were measured by electrochemiluminescence assay(ECLA),ADA from pleural effusions were measured by enzyme rate assay,and the clinical value of combined detection in the differential diagnosis of pleural effusion was evaluated.Results The levels of ADA(65.89±19.81 U/L) in hydrothorax fluid group with tuberculous pleural effusion were beth higher than those in the groups with inflammatory pleural effusion (17.33±16.58) U/L and malignant pleural effusion(27.44±22.64) U/L (q=12.19 and 10.72,P＜0.01).The positive rate of A DA was 82.88% (29/135) in hydrothorax fluid group with tuberculous pleural effusion,13.41% (11/135) in malignant pleural effusion and 11.11% (2/135) in inflammatory pleural effusion (X~2=59.07,P＜0.01).The levels and positive rate of CEA,CA153,NSE,and CA199 in serum and hydrothorax fluid group with malignant pleural effusion were both higher than those in the group with tuberculous pleural effusion (P＜0.05).Compared with the group with malignant pleural effusion,the levels of CA153 and CA199 in serum and the levels and the positive rate of NSE in serum and hydrothorax fluid were not statistically different in inflammatory pleural effusion group.In the 82 cases with malignant pleural effusion,the positive rate of the four kinds of serum tumor markers including CEA,CA153,NSE and CA199 was 74.39% (61/82) and the positive rate of those hydrothorax fluid tumor markers was 82.93% (68/82).Conclusions Combined detection of ADA,CEA,CA153,NSE and CA199 is of some significance to the differential diagnosis of pleural effusion.

This study examined the effects of a combined surgery of sleeve gastrectomy (SG) and modified jejunoileal bypass (JIB) on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 (GLP-1) and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol: SG-JIB (n=12), SG (n=12), JIB (n=12) and sham surgery groups (n=10). In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum (25 cm from the ligament of Treitz) to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.

Objective To establish a quantitative detection method for Mycobacterium tuberculosis by immunomagnetic capture combined with PCR-ELISA detection system with double internal standards(IMC-PCR-ELISA) .Methods The immunomagnetic (Dynabeads? ) which could specifically capture Mycobacterium tuberculosis were prepared .According to Mtp40 and IS6110 gene sequence of Mycobacterium Tuberculosis ,2 pairs of primers(upstream primer was modified with Biotin at 5′end) ,2 same-length mutant fragments with PCR amplified fragments ,and 3 capture probes(modified with digoxigenin at 3′end) were designed .Myco-bacterium tuberculosis were captured by immunomagnetic ,then detected by PCR-ELISA with double internal standards .Results The IMC-PCR-ELISA method could yield quantitative results in about 4 h with a detection limit at 5 × 103 copies/mL .There was a fine linear relationship between the copies of Mtp40(IS6110)in fact and in the calculation through formula when the concentrations of low internal standards were 30-70 copies/mL and the concentrations of high internal standards were 8 000-12 000 copies/mL (r2 =0 .998) .No nonspecific amplification was observed .Conclusion A rapid and quantitative method for the detection of Myco-bacterium tuberculosis was established successfully .The IMC-PCR-ELISA method was rapid ,sensitive ,secific and quantitative .

OBJECTIVE:To change traditional working mode of drug storehouse by applying intelligent system,improve drug storage management,improve work efficiency and quality of drug storehouse,and to provide reference for hospital drug storehouse information management. METHODS:The changes of drug storehouse working mode and management in our hospital were compared before and after the application of intelligent drug storehouse management system. The time taken to complete individual work and the times of error occurrence 12 weeks before and after the application of the system were adopted as indexes to evaluate the effects of the system. RESULTS:Through the combination of Internet+Internet of things bar code,radio frequency identification,electronic tags,etc.,intelligent drug storehouse management system,which included temperature and humidity management,drug storehouse management,supply chain management three modules,was established in our hospital. Its application improved the drug storehouse working mode and process,strengthened the drug storehouse management in respect of staff,supplier,cold chain drugs and special drugs. Before application,average weekly time-consuming of drug shelfing,bill warehousing,outgoing and deliverying and inventory were(11.92 ± 0.701)h,(13.96 ± 0.752)h,(14.96 ± 0.542)h,(4.58 ± 0.376)h;the times of errors within 12 weeks were 10,8,9,2,respectively. After application of the system,average weekly time-consuming were(9.83±0.718)h,(11.29±0.753)h,(9.91±0.557)h,(3.00±0.316)h,respectively(vs. before application, all P<0.05). The times of errors within 12 weeks were 1,1,2,0. CONCLUSIONS:The application of intelligent drug storehouse management system optimizes workflow of drug storehouse in our hospital,strengthens the management of drug storehouse,and improves working efficiency and quality of the drug storehouse.

OBJECTIVE To invest igate the immediate to middle-term outcome of operation for 22 children with first branchial cleft anomalies(FBCA). METHODS Twenty-two hospital ized cases who underwent s urgery for fi rst branchial cleft a nomalies f rom Jan. 2010 to Jan. 2017 were included in the study. Among them, 14 patients were male and the others were female. The median age at operation was 4.0 years old(11 months to 12 years old), and the weight of body was 14 kg(10 kg to 37 kg). There were 11 cases complicated with infection before operation. Eight patients had a history of incision and drainage. RESULTS Thirteen patients were diagnosed as Work Type I and the others were Type II. There were 2 cysts, 9 sinuses and 11 fistulas. All of the patients underwent surgery to remove the tract of FBCA. Based on the intraoperative anatomy, the tract ran superficial to the facial nerve in 15 cases, deep to it in 2 and passed between the branches in 5. There were no severe postoperative complications except 3 facial paralyses. At a median followup of 46 months (range from 7 to 84 months), one of the 3 patients with facial paralyses developed into normal and the other two became permanent. None of the patients had postoperative external auditory canal stenosis. There were 2 cases of recurrence who accepted a total of another three operations, and the others were free from reoperation. CONCLUSION Complete excision of the tract is the only way to cure FBCA, which has a close relationship with facial nerve. The surgical approach should be chosen according to the various types.

This study examined the effects of a combined surgery of sleeve gastrectomy (SG) and modified jejunoileal bypass (JIB) on the body weight,food intake,and the plasma levels of active glucagon-like peptide-1 (GLP-1) and total ghrelin of rats.Rats were divided into 3 groups in terms of different surgical protocol:SG-JIB (n=12),SG (n=12),JIB (n=12) and sham surgery groups (n=10).In SG-JIB group,rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum (25 cm from the ligament of Treitz) to the ileum 25 cm proximal to the cecum.The body weight and food intake were evaluated during 10 consecutive weeks postoperatively.The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay.The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain.The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones.It was concluded that SG-JIB could efficiently reduce the body weight and food intake,alter obesity-related hormone levels of the rats,indicating that SG-JIB may be potentially used for the treatment of obesity.

Objective: To investigate the effect of immediate bone grafting at mandibular first molar extraction socket on maintaining alveolar bone height after space closure. Methods: Thirty adult orthodontic patients who need to extract mandibular first molar, totally 38 target teeth, were included. The samples were divided into two groups randomly: graft group and non-graft group. All extraction space was closed orthodontically. Dental models of all patients were taken before extraction (T0), before space closure(T1) and after space closure (T2). The distance, time of the space closure and the velocity of tooth movement were recorded. Probing depth (PD) and clinical attachment level (CAL) at six sites (mesial buccal, buccal, mesial lingual, lingual, distal buccal and distal lingual) on adjacent teeth were measured before extraction (T0) and after space closure (T2). Cone-beam CT (CBCT) was taken at T0 and T2 to compare the changes of alveolar bone height at six sites on adjacent teeth using Invivo Dental 5.0 software. Results: The extraction space in both graft group and non-graft group was closed successfully. However, the space in graft group was closed more slowly than in non-graft group. In graft group, PD and CAL at the six sites on both the second molar and the second premolar did not change significantly after space closure, and CBCT showed that the alveolar bone height of the second premolar had no significant difference after treatment. In non-graft group, alveolar bone height decreased in both adjacent teeth and periodontal attachment loss was found after space closure. On average, alveolar bone height and periodontal attachment of the second premolar decreased (0.75±0.16) mm and (0.64±0.15) mm, respectively. Meanwhile, alveolar bone height and periodontal attachment of the second molar decreased (0.79±0.23) mm and (0.80±0.24) mm, respectively. Conclusions Bone graft immediately after mandibular first molar extraction could delay alveolar bone resorption and preserve the periodontal attachment of the adjacent teeth during space closure. However, the procedure could slow down tooth movement.

Objective: To summarize the clinical characteristics of pilomatricoma in children and analyze the preoperative diagnostic method. Methods: 468 cases (479 tumors) of pilomatricoma in children were treated in Department of Plastic and Maxillofacial Surgery, Wuhan Children’s Hospital from January 2013 to January 2018. All cases were confirmed by pathology after operation. There were 224 males and 244 females, aged from 3 months to 13 years and 10 months. The general situations, case histories, physical signs, auxiliary examinations and preoperative diagnoses of all patients were analyzed retrospectively. SPSS 22.0 software was used for statistical analysis of data. Median or mean±standard deviation was used for describing measurement data, and component ratio or rate was used for describing counting data. Results: The peak age was 0-2 years old, accounting for 47.22%(221/468). The male to female ratio was 1∶1.09. The most common site of lesions was head(348 cases), followed by neck(76 cases), upper limbs(40 cases), trunk(10 cases) and lower limbs(5 cases). All patients had histories of subcutaneous mass, 85.90%(402/468) had histories of tumor growth, 16.24%(76/468)had pain, 7.91%(37/468) had histories of infection, 28.42%(133/468) had histories of previous treatment, and 12.18%(57/468) had histories of external stimulation. The masses were (1.2±0.6) cm(from 0.3 cm to 3.5 cm) in diameter. By inspection, 98.33%(471/479) of skin overlying the tumor were intact, and 63.29%(269/425) were pale blue. By palpation, 79.62%(375/471) of masses were hard, 100% adhered to the skin, 94.15%(451/479) didn’t cause tenderness, 31.73%(152/479) appeared "tent sign" , and 27.77%(133/479) appeared "teeter-totter sign" . The diagnostic accuracy rate of ultrasonographic examination was 75.24%(155/206). 31.55%(65/206) showed hypoechoic nodule containing internal hyperechoic dots, 27.67%(57/206) showed hyperechoic band with wide acoustic shadowing below. 88.83%(183/206) of Color Doppler Flow Imaging showed peripheral blood flow signal around the nodule, and the internal blood flow signal decreased or disappeared. The diagnostic accuracy rate of CT examination was 98.44%(126/128), 58.59%(75/128) of plain CT scans showed high density mass shadows of which the internal densities were homogeneous or heterogeneous. 39.84%(51/128) of plain CT scans showed soft tissue density mass shadows of which the internal densities were heterogeneous, and the dot high density shadows in different size scattered. The diagnostic accuracy rate of needle aspiration cytology was 61.54%(8/13). The preoperative diagnostic accuracy rate was 81.63%(391/479). Conclusions Typical pilomatricoma often occurs on a child’s head. The overlying skin is pale blue. The tumor is hard in texture, adheres to the skin, and appears a "tent sign" or "teeter-totter sign" . Ultrasonography and CT examinations suggest calcification in the subcutaneous lesion, which is helpful for preoperative diagnosis. Needle aspiration cytology can be used for differential diagnosis of atypical case.

Background Silica nanoparticles (SiNPs) enter the human body through respiratory tract, digestive tract, and skin, causing body damage. Lung is one of the main damaged organs. Objective To observe the expressions of complement activated fragment C3a and its receptor C3aR in the lungs of mice exposed to SiNPs through respiratory tract, and to explore the involvement of C3a/C3aR in lung injury induced by SiNPs exposure. Methods The ultrastructure of SiNPs (particle size 5-20 nm) was determined under a transmission electron microscope, and the hydrodynamic diameter and surface Zeta potential of SiNPs were determined using a nanoparticle size analyzer. A total of 88 SPF C57BL/6J mice were randomly divided into five groups: a blank control group without any treatment (14 mice), a vehicle control group treated with 50 μL stroke-physiological saline solution by intratracheal instillation (14 mice), and three SiNPs exposure groups (low-dose group, medium-dose group, and high-dose group with 20 mice in each group, who were given 50 μL SiNPs suspension of 7, 21, and 35 mg·kg⁻¹ respectively and exposed once every 3 days for 5 times). The mice were anesthetized on day 1 (1-day model group) and day 15 (15-day model group) after exposure, then sacrificed after extraction of bronchoalveolar lavage fluid (BALF), and lung tissues were retained. The morphological changes of lung tissues were observed by HE staining, the expression level of C3a in BALF was detected by enzyme-linked immunosorbent assay, the deposition of C3a and C3aR in lung tissues were observed by immunohistochemistry, the protein expression level of C3aR was determined by Western blotting, and the localization and semi-quantitative detection of C3a and C3aR in lung tissues was observed by immunofluorescence. Results SiNPs agglomerated in stroke-physiological saline solution. The average hydrodynamic diameter was (185.60±7.39) nm and the absolute value of Zeta potential was (43.33±0.76) mV. The condition of mice in the 1-day model group and the 15-day model group was good, while 2 mice died in the medium-dose group of the 1-day model group due to misoperation. The autopsy results of the two mice showed congestion of the lung tissue, emphysema, and no imperfection of trachea integrity. No death was observed in other dose groups. The HE staining results showed pathological damage to the mouse lung, including alveolar wall thickening and inflammatory cell infiltration after SiNPs exposure. The pathological damage became more serious with the increase of dose. Regarding pathological changes, the 15-day model group was slightly relieved compared with the 1-day model group, but there were still pathological changes. The enzyme-linked immunosorbent assay results showed that there was no difference in the expression level of C3a between the blank control group and the vehicle control group (P＞0.05), the expression levels of C3a in the medium-dose group and the high-dose group were significantly higher than that in the vehicle control group (P<0.05). The immunohistochemistry results showed that C3a deposition was consistent with the enzyme-linked immunosorbent assay results. The Western blotting and the immunohistochemistry results showed that C3aR expression was low in the blank control group and the vehicle control group, while the expression in each dose group tended to increase with the increase of dose. The immunofluorescence results showed that the fluorescence signals of C3a and C3aR were weak in the blank control group and the vehicle control group in the 1-day model group and the 15-day model group, while the fluorescence signals in the lung tissues of mice in the SiNPs exposure groups tended to increase with the increase of dose. Conclusion The increased expressions of C3a and C3aR in complement activation may be related to lung injury induced by intratracheal instillation of SiNPs, suggesting that C3a/C3aR may be involved in lung injury induced by SiNPs exposure.