Objective To investigate the correlation between the serum levels of homocysteine (Hcy) ,folate acid (FA) and vita‐min B12 (VitB12 ) with cerebral infarction .Methods The enzymatic cycling method and chemiluminescence immunoassay were used to detect the serum Hcy ,FA and Vit B12 levels in 60 patients with cerebral infarction ,and then the detection results were compared the results of 40 people undergoing physical examination in the same period .Results The serum Hcy level in the cerebral infarction group was (23 .16 ± 8 .17)μmol/L ,which was significantly higher than (8 .09 ± 2 .45)μmol/L in the control group(P<0 .01) ,and the serum FA and Vit B12 levels in the cerebral infarction group were (6 .12 ± 2 .19) ng/mL and (323 .92 ± 133 .79)μmol/L ,which were in the control group lower than (10 .57 ± 5 .70) ng/mL and (530 .85 ± 168 .56)μmol/L in the control group (P<0 .01) .The serum Hcy level in the cerebral infarction group showed the negative correlation with FA and VitB 12 levels ( r1 = - 0 .444 , r2 = -0 .535 ,P<0 .05) .Conclusion High hyperhomocysteinemia is an independent risk factor of cerebral infarction and is related to the decrease of FA and VitB12 .

Objective To investigate the clinical value of serum iron(Fe),total iron binding capacity(TIBC),serum ferritin(SF), folic acid(FA)and vitamin 12(ViB12 )in the diagnosis and treatment of chronic renal failure(CRF).Methods Fasting blood sam-ples were collected from 72 patients with CRF and 83 normal controls.Then the serum SF,ViB12 and FA contents were measured by the ARCHITECT i2000SR fully automatic chemiluminescence immunoassay analyzer;serum Fe and TIBC were detected by the VITORS FS 5.1 dry biochemical analyzer;RBC,HGB,HCT and MCV were analyzed by the Mindray BC-6800 complete automated blood counter.The detection results were performed the statistical analysis by the SPSS16.0 software.Results The levels of TIBC,RBC,HGB and HCT in the CRF patients were significantly lower than those in the control group(P <0.05);while the SF and ViB12 levels were significantly higher than those in the control group;serum Fe and MCV had no statistical difference compared with the control group(P >0.05);the FA level in the female patients was lower than that in the control group,but which in the male patients had no statistical differences compared with the control group(P >0.05).Conclusion The indexes of anemia associat-ed metabolin in the CRF patients can provide certain reference value for the diagnosis and treatment of chronic renal fail and has cer-tain guidance significance for correcting anemia caused by renal insufficiency.

Objective To investigate the influence of menstrucal cycle and anatomic site on the fractional anisotropy (FA) values of diffusion tensor imaging (DTI) in normal breast. Methods Prospectively enrolled 96 volunteers, who have identified with normal menstrucal phase and without breast diseases were found via the breast examination, ultrasound and MRI scan. The cases were divided into three groups according to menstrucal phase: menstrual period group(menstrual cramps 1 to 6 d), proliferative phase group(menstrual cramps 7 to 14 d) and secretory phase group(menstrual cramps 15 d to the next), and each group consisted of 32 subjects. All subjects were performed bilateral breast cross-sectional T1WI, T2WI, DWI and DTI scaning. On the nipple level figture, the mammary gland was divided into three regions including the anterior, central and posterior parts, and the FA values of the different phases and regions were measured. The Kruskal-Wallis H test was applied to analyse the difference of FA values in different menstrual phase and anatomic site. Results The FA values of the anterior region in menstrual phase, proliferative phase and secretary phase were 0.21 ± 0.07, 0.24 ± 0.09 and 0.17 ± 0.07, and the difference had significant difference(P=0.014).The FA values of the central region were respectively 0.15±0.08, 0.18±0.09 and 0.15±0.07, and without the statistically significant difference(P=0.090). The FA values of the posterior region were 0.21 ± 0.11, 0.24 ± 0.13 and 0.16 ± 0.11, and also showed significant difference(P=0.002). In different regions, the difference of FA values between menstrual phases and proliferative phases were also had statistically significant(P=0.018, 0.045, respectively). In the same region, the FA value was lowest in the secretary phase, and the proliferative phase was slightly higher than menstrual phase. Conclusion The FA values are affected by menstrual cycle and anatomic site.

Objective To evaluate the main performance of ABBOTT ARCHITECT C160000 biochemistry analyzer,and to judge whether the performance meets the laboratory requirement.Methods According to the clinical laboratory management meth-od and the requirement of accreditation of national laboratory,the precision,accuracy and linearity of the 17 test items(Urea,Cre, UA,Glu,etc.)were analyzed by the CLSI EP5-A2 document,CLSI EP9-A2 document and CLSI EP6-P document;the quotative ref-erence ranges of the 17 test items were verified.Results The coefficient of variation(CV)in within-batch precision of Urea,Cre, UA,Glu,etc.was ≤1/4 CLIA′88 standard and CV in the between-batch precision ≤1/3CLIA′88 standard;in the accuracy test,the relative bias of the 17 test items≤1/2CLIA′88 standard;the linearity of the 17 items was good(r2 >0.95);the cited reference range of various detection items was suitable.Conclusion The performance of the ABBOTT ARCHITECT C160000 automatic biochem-istry analyzer meets the laboratory demand.

Objective To investigate the comparability of the activity detection of 6 common serum enzymes by different bio-chemical detecting systems at the same laboratory to provide the basis for realizing the traceability and comparability of serum en-zyme detection.Methods The detection system consisted of the Hitachi 008 biochemical analyzer,and original reagents,C-fas cali-brator and controller of Roche was taken as the reference system X(comparison method)and the detection system consisted of the ABBOTT ARCHITECT C16000 biochemical analyzer,reagents and calibrator of Zhongsheng,and controller of BIO-RAD was taken as the detecting systemY (laboratory method),which were used to detect the accuracy and precision of fresh serum enzymes inclu-ding ALT,AST,ALP,GGT,LDH and CK according to the NCCLS document EP9-A2.Then the enzyme activity results detected by the Y and X methods were compared and the relative error(SE%)was calculated.The comparability of the results detected by these two kinds of different detection systems was judged with 1/2 of allowable error in the external quality assessment stipulated by CLIA′88 as the standard.Results The accuracy and precision of the activity detection results of 6 enzymes by the Hitachi 008 and ARCHITECT C16000 biochemical analyzers all conformed to the requirements and the systematic error was clinically acceptable. Conclusion In measuring same test item by two or more detection systems,the method comparability and the bias assessment should be performed for ensuring the accuracy and comparability of the detection results.

In this study, an analytical method was developed and used to quantify simultaneously protocatechuic acid, neochlorogenic acid, cryptochlorogenic acid and 1, 3-dicaffeoylquinic acid--four bioactive compounds contained in Fructus Xanthii using UPLC. The contents of four phenolic components of 28 batches of samples collected from different product areas and markets were determined and compared by means of this established method. The mobile phase was composed of methanol and water containing 0.1% phosphoric acid. Chromatography was monitored at dual-wavelengths--220 and 327 nm. Flow rate was 0.4 mL x min(-1) and column temperature was 35 degrees C. The correlation coefficient between concentration and chromatographic peak area of protocatechuic acid, neochlorogenic acid, cryptochlorogenic acid and 1, 3-dicaffeoylquinic acid was over 0.9999 in the range of 0.3570-35.70, 2.500-250.0, 1.060-106.1, 1.010-101.0 microg x mL(-1), respectively. The average recoveries of the four compounds were 97.68%, 99.55%, 97.92% and 100.4%, respectively. In conclusion, the established method can rapidly attain an accurate and reproducible result used to control the quality of Fructus Xanthii.

Objective To study the risk factors of complications after hepatectomy for intrahepatic stone.Method Clinical data of 363 patients with hepatolithiasis receiving elected hepatic resection in past 4 years in our hospital were analyzed retrospectively.Postoperative complications were recorded.Possible risk factors pertaining to the development of complications were identified using univariate and multivariate analysis.Results the surgical mortality was 0.6%(2/363).Postoperative complications occurred in 110 of 363 patients(30.3%).The morbidity included wound infection/liquafication in 42 cases(11.6%),pleural effusion in 41(11.3%),subphrenic collection in 36 (9.9%),bile leakage in 21(5.8%),intra-abdominal collection/infection in 13(3.6%),gastrointestinal bleeding in 3(0.8%),biliary hemorrhage in 2(0.6%),hepatic function insufficiency in 1 (0.3%).The multivariate logistic regression analysis identified that previous history of biliary surgery (P=0.042,odds ratio[OR]=0.617,95%confidence interval[CI]:0.388 to 0.982)and operative time(P=0.0001,odds ratio[OR]=0.994,95%confidence interval[CI]:0.991 to 0.997)were the independent risk factors for development of complications after hepatoectomy for hepatolithiasis.Conclusion Previous history of biliary duct surgery and operative time are the independent risk factors for development of complications after hepatoectomy for intrahepatic stone.For patients with previous biliary surgery,adequate preoperative preparation,improving operative skills and shortening operative time are critical important to prevent occurrence of complications.

ObjectiveTo investigate the protective effects and its mechanism of ischemia postconditioning (IPO) in hepatic ischemia-reperfusion injury (IRI) in liver cirrhotic rats.MethodsThirty liver cirrhotic Sprague-Dawley (SD) rats were randomly divided into three groups according to the random table methods: ischemia postconditioning (IPO) group, IRI group, and pure hepatectomy (PH) group with 10 rats in each group. Rats in IPO group underwent partial hepatectomy (40%), and the first portal was occluded for 20 min, then 3 times of ischemia-reperfusion were performed, and ifnally continuous reperfusion. Rats in IRI group underwent partial hepatectomy (40%), and the ifrst portal was occluded for 20 min, then continuous reperfusion was performed. Rats in PH group underwent partial hepatectomy (40%) only. Inferior vena cava blood was collected at 6, 24 h after operation. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), proportion of cluster of differentiation (CD) 4+, CD8+, regulatory T cells (Treg) and levels of interleukin (IL)-4, IL-10 were tested. Comparison of three groups was conducted by one way analysis of variance and pairwise comparison by LSD-t test.ResultsAfter 6 h reperfusion, levels of ALT and AST in IPO group [(1 623±378) , (1 993±469) U/L] were signiifcantly lower than those in IRI group [(2 690±549) , (3 020±577) U/L] (LSD-t=-4.21,-3.72; P<0.05). After 24 h reperfusion, levels of ALT and AST in IPO group [(307±76) , (555±137) U/L] were still signiifcantly lower than those in IRI group [(518±105) , (1 050±355) U/L] (LSD-t=-4.06,-3.37;P<0.05). After 6 h reperfusion, proportion of CD4+, CD8+, CD4+/CD8+ ratio, Treg, and levels of IL-4, IL-10 in IPO group were (57±5) %, (25±3) %, 2.3±0.5, (8.9±0.4) %, (1.27±0.25) mg/L, (0.61±0.03) mg/L, respectively. While in IRI group, they were (52±6)%, (12±3) %, 4.5±0.8, (7.3±0.3) %, (0.66±0.11) mg/L, (0.34±0.06) mg/L, respectively. In IPO group, CD8+, Treg, IL-4 and IL-10 increased signiifcantly, while CD4+/CD8+ ratio decreased signiifcantly, compared with those in IRI group (LSD-t= 7.74, 6.67, 5.52, 9.31,-6.69;P<0.05).ConclusionIPO can prevent from hepatic IRI injury in liver cirrhotic rats through decreasing the immune injury.

ObjectiveTo investigate the value of preoperative prognostic nutritional index (PNI) in postoperative survival prognosis of hepatocellular carcinoma (HCC) patients.Methods Clinical data of 322 HCC patients undergoing radical resection in the First Affiliated Hospital of Sun Yat-sen University between January 2006 and December 2009 were retrospectively studied. Among the 322 patients, 286 were males and 36 were females with the age ranging from 21 to 79 years old and the median age of 51 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. PNI value was calculated according to the examination results 1 week before surgery, then the patients were divided into the high PNI group (n=253) and low PNI group (n=69). The relationship between PNI and postoperative survival time was observed, and the value of preoperative PNI in postoperative survival prognosis was analyzed. The survival analysis was conducted using Kaplan-Meier method and Log-rank test, and the multivariate analysis was conducted using Cox proportional hazards model.ResultsThe 1-, 3-, 5-year disease free survival rate was respectively 48.0%, 34.9% and 31.3% in high PNI group, and 33.3%, 15.8% and 11.7% in low PNI group. The disease free survival in high PNI group was significantly better than that in low PNI group (χ2=9.990,P<0.05). The 1-, 3-, 5-year overall survival rate was respectively 72.3%, 49.0% and 42.6% in high PNI group, and 65.2%, 36.2% and 25.9% in low PNI group. The overall survival in high PNI group was significantly better than that in low PNI group (χ2=8.172,P<0.05). The results of the multivariate analysis showed that AFP, tumor number, tumor diameter, portal vein tumor thrombus (PVTT) and PNI were the independent risk factors for disease free survival rate (HR=1.355, 0.783, 2.295, 1.920, 0.710;P<0.05), and tumor number, tumor diameter, PVTT and PNI were the independent risk factors for overall survival rate (HR=0.780, 2.340, 2.013, 0.653;P<0.05).ConclusionsPreoperative PNI is the independent risk factor for postoperative survival prognosis of HCC patients and can be used as the common index for predicting postoperative survival of HCC patients.

Objective:To investigate the effect of complex decongestive therapy(CDT) on elephantiasis and skin texture improvement.Methods:The clinical data of patients with elephantiasis of lower limbs who were admitted to the Department of Plastic Surgery, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2018 were retrospectively analyzed. The patients with elephantiasis of different causes were treated with CDT for 1 course (4 weeks). The skin texture parameters (skin water content, transepidermal water loss, skin fibrosis), limb circumference and segmental edema were measured before and after treatment and analyzed by paired t test. Pearson correlation analysis was used to detect the correlation between segmental edema and skin texture parameters before and after treatment. The subjective feelings of patients were recorded during follow-up. A self-designed online questionnaire was used to follow up the patient’s disease control status, including the limb circumferences, changes in quality of life (life, work, social and emotion), the adaptability to bandages and elastic socks. Data were classified and analysed as excellent, good, medium and poor.Results:A total of 20 patients were included, including 16 females and 4 males. The average age was 50.45 years (ranged 9-70 years). 5 cases were primary lymphedema and 15 cases were secondary lymphedema. The duration of the disease ranged from 2 years to 27 years, with an average of 8.4 years. After 1 course of treatment, the skin texture was significantly improved. The skin water content decreased from 55.6%±7.4% before treatment to 42.1%±7.4% after treatment ( P< 0.001). The transepidermal water loss decreased from (14.981±5.699) g·m -2·h -1 before treatment to (9.312±2.590) g·m -2·h -1 after treatment. The skin fibrosis decreased from (0.087±0.042) N before treatment to (0.065±0.033) N after treatment ( P<0.001). The circumference of the affected limb decreased from (11.09±3.14) cm before treatment to (4.82±2.83)cm after treatment ( P<0.001). The segmental edema decreased from (4.00±2.14)L before treatment to (1.21±0.78) L after treatment. Segmental edema was positively correlated with skin water content, transepidermal water loss, and skin fibrosis ( r=0.447, r=0.429, r=0.751, P<0.05). The patients were followed up for 6 months after treatment. The circumference control was excellent in 13 cases, good in 5 cases and moderate in 2 cases. The quality-of-life changes were excellent in 16 cases, good in 3 cases, medium in 1 case. The adaptability of elastic material was excellent in 9 cases, good in 8 cases, medium in 2 cases and poor in 1 case. Conclusions:CDT can reduce subcutaneous edema, effectively reduce limb volume, decrease skin fibrosis, improve skin barrier function, improve skin texture, restore the appearance of the limb and improve patients’ quality of life.