Objective To evaluate the role of serum immunoglobulin G4 (IgG4) in differentiating autoimmune pancreatitis (AIP) from pancreatic cancer(PC).Methods The database,including Medline,EMBASE,Science Direct,Springer link,CBM,Wanfang,VIP and Cnki were searched by computer and the publication date was before April 1,2015.The studies on evaluating the accuracy of IgG4 in differentiating AIP from PC were screened and selected according to strict determined inclusion and exclusion criteria.Quality assessment was made by QUADAS scale.The publication bias were assessed by Stata12.0 software.The heterogeneity of included articles,calculate the pooled sensitivity,specificity,positive likelihood,negative likelihood were anylyzed by Meta-Disc1.4 software,respectively,and draw the summary ROC (SROC) curve.Results A total of 13 English articles were included and 1403 patients were involved.The pooled sensitivity was 74％ (95％ CI 70％ ～ 78％),the pooled specificity was 93％ (95％ CI 91％ ～ 95％),the positive likelihood ratio was 10.74 (95％ CI 7.16 ～ 16.11),the negative likelihood ratio was 0.25 (95％ CI 0.17 ～0.35) and the area under SROC curve was 0.9340.Conclusions IgG4 has high diagnostic efficacy but low misdiagnosis rate in differentiating AIP from PC,which can be used as one of early diagnostic markers for AIP.

Objective To evaluatethe curative effect of the integrative treatment of point injection, warm acupuncture and Chinese medicine enema for the chronic pelvic inflammatory disease.Methods A total of 86 patients with chronic pelvic inflammatory diseasewere divided into control group and treatment group, 43 patients in each group , according to the random number table. The control group was treated by warm acupuncture combined with Chinese medicine enema, while the treatment group was treated with point injection plus the basis of control group. The levels of serum CRP, IL-1 and IL-6 were detected by enzyme linked immunosorbent assay,the plasma viscosity and hematocrit were detected by automatic blood rheological test instrument,the symptom scores of 2 groups were compared before and after treatment, the clinical efficacy was evaluated and the recurrence rate was observed. Results The clinical effective rate of treatment group patients was 97.7% (42/43), and the control group 81.4% (35/43). The difference between two groups was significant (χ2=6.081,P=0.014). After treatment, the levels of CRP (7.53 ± 3.44 mg/L vs. 10.11 ± 3.02 mg/L,t=-3.696), IL-1β (26.37 ± 13.98 pg/mL vs. 36.33 ± 4.02 pg/mL,t=-4.490) andIL-6 (23.31 ± 10.11 pg/mlvs. 29.56 ± 4.27 pg/ml,t=-3.734)in the treatment group were significant lower than those in control group (P<0.05). The scores of pain (2.13 ± 0.55vs.2.71 ± 0.62,t=-4.589), tiredness (1.07 ± 0.98 vs. 2.53 ± 0.52,t=-8.630), Body cold (1.51 ± 0.51 vs. 2.21 ± 0.67,t=-5.451), menstrual symptoms (1.27 ± 0.97 vs. 2.29 ± 0.78, t=-5.374) and total points (6.13 ± 3.94vs. 8.55 ± 1.82,t=-3.656) in the treatment group were significant lower than those in control group (P<0.05). The plasma viscosity (1.13 ± 0.25 mPa?svs. 1.41 ± 0.32 mPa?s,t=-4.521) and the red blood cells deposited (0.27% ± 0.08% vs. 0.41% ± 0.07%,t=-8.636) in the treatment group were significant lower than those in control group (P<0.05). The recurrence rate of treatment group was none, while 11.43% (4/35) in control group. Thus, the recurrence rate of treatment group was significantly lower than the control group (χ2=5.063,P=0.024). Conclusions The integrative treatment of point injection, warm acupuncture and Chinese medicine enema can reduce the level of inflammatory factors in patients with chronic pelvic inflammatory disease, improve the blood microcirculation, and reduce the recurrence rate.

OBJECTIVE:To discuss the countermeasure on the quality improvement of the drug clinical trials in our hospital based on the discovery of key links of the quality of clinical trials. METHODS:Quality results of 14 drug clinical trials in 10 ma-jors from the drug clinical trial institute in our hospital in 2014 were investigated. Referring to the grading and classifying methods of the inspection problems in European Medicines Agency,the key links of occurring problems were analyzed,and the effects of interventions for key links were evaluated. RESULTS:In 2014,totally 125 important and general problems were found,in which, the numbers of problems occurred in case report form filling,informed consent of subjects,enrolling and screening of subjects,in-vestigational products management accounted for 79.20%. The above 4 links were the key links affecting quality of drug clinical tri-als. According to strengthening the training about relevant knowledge of the researchers,improving system and standard operation procedures management,enhancing link quality control,introducing project clinical research coordinator,developing centralized drug management and other interventions,the total numbers of found important and general problems in 2015 and 2016 were 68 and 59,respectively. Compared with 2014,the differences were statistically significant(P<0.05). The numbers of found important problems in 2015 and 2016 were 7 and 4,respectively. Compared with 2014(4 important problems),the differences were not sta-tistically significant (P>0.05). There were no severe problems during 2014-2016. After interventions,numbers of occurring prob-lems in majors with less complex drug clinical trial had obviously declined in 2016. Compared with 2014,the differences were sta-tistically significant (P<0.05). While the major with relatively high complexity of drug clinical trial had no obvious decline in 2016. Compared with 2014,the differences were not statistically significant(P>0.05). CONCLUSIONS:Controlling the key links in drug clinical trial process can obviously reduce the occurrence of general problems while has little effect on the occurrence of im-portant problems. It is different for different majors in undertaking drug clinical trial projects,so as the links and degree of occur-ring problems. It should be distinguished in quality control checking.

Objective To study the risk factors of mortality in severe sepsis and septic shock patients. Methods 142 patients with severe sepsis and septic shock in ICU were observed and divided into alive group (98 patients)and dead group (44 patients)by using hospital mortality.The risk factors of mortality in severe sepsis and septic shock patients were assessed by binary logistic regression.Results Independent mortality risk factors were inotropic agents (OR =4.329,95%CI:1.045 -17.937,P =0.043),blood glucose >10 mmol/L (OR =3.771,95%CI:1.214 -11.710,P =0.022)and APACHE Ⅱ score (OR =3.098,95%CI:2.012 -4.760,P =0.000),while PaO2 /FiO2 after early goal -directed therapy (EGDT)was protective factor (OR =0.682,95%CI:0.500 -0.930, P =0.016).Conclusion Severe sepsis and septic shock patients with inotropic agents,blood glucose >10mmol/L, high APACHE Ⅱ score and decreased PaO2 /FiO2 after EGDT indicate poorly prognosis.

Evacuation of intracerebral hematomas in 38 hypertensive patients was reported. Hematomas were found in the internal capsule in 24 patients, subcortex in 5. cerebellum in 7 and brain stem in 2. The volume of hematoma was less than 2ml (in the brain stem) in 2 patients, 20-50ml in 15, and over 100ml in 6. The fluid hematoma was to tally aspirated with stereotactic technique in 7 patients. In 17 patients, over 80% of hematoma was evacuated, and in 14 about 60-80% of hematoma was evacuated by the same technic. The results of the operation were good in 11 patients (29.0%), while in 29% there was a mild disability, and in 12 (31.5%) there was a marked disability, 4(10.5%) died.

Chloroplast genome sequences have comprehensive application prospects in DNA barcoding and chloroplast engineering in traditional Chinese medicine. The complete chloroplast genome of Magnolia officinalis sequenced by high-throughput pyrosequencing and a sequencing procedure was established. Fourteen contigs were obtained after de nove assembly. The sequencing percent of coverage was 99.99%. The chloroplast genome is 160 183 bp in size, and has a typical quadripartite structure with the large (LSC, 88 210 bp) and small copy (SSC, 18 843 bp) regions separated by two copies of an inverted repeat (IRs, 26 565 bp each). chloroplast genes were successfully annotated, of which 17 genes located in each IR region. The chloroplast genome features in Magnolia officinalis are nearly identical to those from other Magnoliid chloroplast genomes. Phylogenetic analyses were performed based on 81 shared coding-genes for a total of 9 Magnolia samples of 5 closely related species. Results showed that distinguishing among species was generally straightforward at the species and population level. This study confirmed the effectiveness of our chloroplast genome sequencing procedure. The chloroplast genome can provide distinguishing differences to help identify Magnolia officinalis and its closely related plants.

To explore the clinical features and common complications of fast resting heart rate (RHR) in hypertensionpatients. Methods: We retrospectively analyzed the entire rest electrocardiogram data of Qingdao study 2000 and Xinyang study2005 in community population elder than 18 years including hypertension patients and non-hypertension subjects. Clinical complications as diabetes, coronary artery disease, hyperlipidemia and stroke, laboratory findings, RHR in ECG, body mass index (BMI), waist to hip ratio and office blood pressure were collected in all participants. Results: A total of 18183 participants were enrolled including 61.6% male, the average age was (45.2±12.7) years including 6763 hypertension patients. Compared with normal BP subjects, hypertension patients had the faster RHR (73.5±11.6) times/min vs (70.6±9.6) times/min, P<0.001 and more hypertension patients combining fast RHR (14.5% vs 6.4%), P<0.001. In hypertension patients, compared with normal RHR patients, fast RHR patients had the elder age (53.9±12.2) years vs (51.8±11.2) years, lower BMI (25.8±3.6) kg/m2 vs (26.4±3.4) kg/m2 and higher ratio of grade 3 hypertension (68.2%vs 59.0%), all P<0.001; higher levels of fasting blood glucose (6.0±2.4) mmol/L vs (5.6±1.5) mmol/L and triglyceride (2.0±1.8) mmol/L vs (1.7±1.3) mmol/L, both P<0.001, higher LDL-C (3.2±0.9) mmol/L vs (3.1±0.8) mmol/L, P=0.001;more patients with diabetes (6.6% vs 3.9%), P=0.007 and stroke (11.1% vs 8.3%), P=0.005. Multivariate regression analysis indicated that with adjusted traditional risk factors, fast RHR was positively related to stroke occurrence in hypertension patients (OR=1.306, 95% CI 1.021-1.671). Conclusion: Fast RHR happened more in hypertension patients than in normal BP subjects; it had the increased risk for stroke occurrence in hypertension patients.

Objective To study the effects of endothelial nitric oxide synthase (eNOS) gene transfection on endothelial progenitor cells (EPCs) transplantation in the process of injured vascular endothelium repair. Methods EPCs were cultured and expanded in vitro. EPCs were transduced with pseudotyped retroviral vectors expressing eNOS gene (pMCV-eNOS-EPCs) or green fluorescent protein gene (pMCV-GFP-EPCs). EPCs with expressing eNOS, GFP or saline were injected respectively into rat injured artery model by tail vein injection after balloon injury and again 24 hours. 14 days after transplantation. eNOS expression in injured artery was detected by RT-PCR, western blot and immunohistochemical methods. The morphology of arterial intima and media was studied by optical microscopy and image analysis system. Results Compared with GFP-EPCs group and control group, the mRNA and protein of eNOS were obviously high expressed in eNOS-EPCs group. EPCs transplantation reduce lumen stenosis and inhibit neointimalhyperplasia (eNOS-EPCs group vs.control group, 0.58±0.05 vs. 1.56±0.21, P < 0.01;GFP-EPCs group vs. control group, 0.84±0.09 vs.1.56±0.21, P < 0.05). eNOS gene transfection could further enhance this anti-proliferative effects (eNOS-EPCs group vs. GFP-EPCsgroup,0.58±0.05 vs. 0.84±0.09, P < 0.05). Furthermore, eNOS modified EPCs could improve the endothelial function of injured vascular endothelium. Conclusions eNOS gene transfection could increase the anti-proliferative effect of EPCs transplantation on injured artery and obviously ameliorate endothelial function.

Objective To investigate the changes of A20 expression stimulated by free fatty acids (FFA) and its pathway.Methods HepG2 cells and U937 cells were stimulated by 0.5 mmol/L mixed FFA.The expression of A20,phosphor-p65 and phosphor-IκBα of neclear factor (NF)-κB pathway and phosphor-c-Jun N-terminal kinase (JNK),JNK,phosphor-extracellular signal-regulated kinase (ERK),ERK,phosphor-p38 and p38 of mitogen-activated protein kinase (MAPK) pathway were detected by Western blotting.The level of interleukin (IL)-12p,IL-1β,tumor necrosis factor (TNF)-α,IL-6,IL-10 and IL-8 cytokines in the supernatant of cell culture were detected by flow cytometry.T-test was performed for statistical analysis.Results The level of A20 changed along with the stimulated time of FFA.NF-κB and MAPK pathways were activated after FFA stimulation.The secretion of IL-6 and IL-8 increased after HepG2 cells stimulated by FFA and both reached peak at 24 hour.Compared with control group,the difference in IL-8 was statistically significant ((423.8 ± 8.9) pg/mL vs (12.4 ± 4.5) pg/mL,t=41.28,P＜0.01).The difference in IL-6 was also statistically significant ((4 082±423.6) pg/mL vs (52.9±29.5) pg/mL,t=9.49,P＜0.01).After U937 cells were stimulated by FFA,the secretion of IL-8 increased compared with control group.And in a certain period of time the secretion was time dependence.The maximum secretion of 24 hours was (200.6±5.7) pg/mL vs (5.0±3.9) pg/mL,and the difference was statistically significant (t=28.16,P＜0.01).IL-10,IL-12p,IL-1β and TNF-α were detected.Both NF-κB pathway and MAPK pathway were detected.Conclusions The in vitro FFA mediated steatotic cell model could induce the expression change of A20 and secretion of inflammatory cytokines.NF-κB and MAPK pathways involved in the response to FFA in HepG2 cells and U937 cells.

This article reports the experience of treatment of 30 cases of temporal epilepsy with surgery. There were 15 male patients and 15 female. The duration of the disease ranged from 5 to 37 years with an average of 13.6 years. 12 patients suffered from grand and petite mal, 8 Jacksonian accompanied by psychomotor epilepsy, and 10 grand mal. Before the operation, the focus with sporadic spikes was found in the temporal lobe with electroencephalogram. Operation: the temporal pole and the medi-basal region were removed in 9 cases, anterior portion of the temporal nesiolobe in 10 cases, temporal neocortical of the temporal lobe in 6 cases, dorsolateral and laterobasal parts in 5 cases. Organic pathological changes were confirmed in all cases by pathological examination. Clinical result of all cases was satisfactory, with an effective rate of 93%. The clinical and pathological changes of epilepsy and efficacy of the treatment are discussed. It is stressed that the localization of the focus of epilepsy depe nds mainly on electroencephalogram. It is very important to look for sporadic spikes using cortical electrode during operation, and complete eradication of the focus is the key to achieve a good treatment effect.