Objective To investigate the role of rheumatoid factor(RF) ,C‐reactive protein(CRP) ,erythrocyte sedimentation rate (ESR) in the diagnosis of rheumatoid arthritis(RA) .Methods 74 RA patients and 90 patients with symptoms similar to RA were recruited in the study randomly .Blood samples were detected for the levels of RF ,CRP ,ESR .The results were compared between two groups .Receiver operating characteristic curve(ROC) was used to access the diagnostic efficiency .Results The levels of RF , CRP ,ESR of RA group were (271 .4 ± 560 .9)IU/mL ,(28 .7 ± 35 .6)mg/L ,(60 .9 ± 40 .1)mm/h ,respectively ,and were higher than those of control group which were (56 .8 ± 189 .3)IU/mL ,(15 .4 ± 24 .7)mg/L ,(45 .1 ± 33 .1)mm/h respectively .ROC analysis re‐vealed that the AUC of RF ,CRP ,ESR and combined detection of the 3 factors were 0 .784 ,0 .666 ,0 .615 ,0 .757 ,respectively with statistical significance(P<0 .05) .Conclusion RF ,CRP ,ESR are useful in the diagnosis of RA ,and RF has the highest diagnostic ef f iciency .

Objective To discuss the diagnostic value of serum cystatin-C(Cys-C) and urinary retinol binding protein(RBP) for the early renal impairment in multiple myeloma(MM) patients .Methods According to estimated glomerular filtration rate(eGFR) , the MM patients were divided into two groups :the normal renal function group(eGFR≥90 mL/min ,n=78)marked group A ,the renal impairment group(eGFR<90 mL/min ,n=40)marked group B .130 healthy subjects were selected as control group .The con-centrations of serum Cys-C ,urinary RBP ,serum creatinine(Cr) and serum urea nitrogen(UN) were measured and compared .Results The levels of Cys-C and RBP in group A were significantly higher than those in the control group(P<0 .01) .There were signifi-cant difference of the levels of Cys-C ,Cr ,UN and RBP levels between group B and control group(P<0 .01) .The sensitivity of the combined detection of Cys-C and RBP was 57 .69% ,significantly higher than single index test(P<0 .05) .Conclusion Compared with traditional biomarkers ,Cys-C and RBP are more sensitive and effective indexes for the diagnosis of early renal impairment in the patients with MM ,and jointed detection of the two biomarkers has important value .

Objective To explore the effects of simvastatin in the treatment of hyperlipidemia fatty liver. Methods Animal models were set up by feeding high caloric diet. Liver index (liver weight/body weight), liver function, blood lipid, liver lipid, the content of MDA in serum and liver were assayed before and after therapy with simvastatin. Results Liver index, blood lipid, liver lipid, and the content of MDA in liver as well as in serum increased significantly ( P

Objective To explore clinical indications and curative effects of microwave coagulation combined with submucous 5-fluorouracil (5-FU) injection in the management of early-stage lower rectal cancer. Methods Nine patients with early-stage lower rectal cancer underwent microwave coagulation with submucous 5-FU injection from January 1996 to December 2002. After the microwave treatment, a retention enteroclysis with 100~200 ml normal saline containing 1.0 g 5-FU was performed once daily for 3 days. Results In 3 patients, levels of carcinoembryonic antigen (CEA), which were preoperatively increased, were reduced below normal limits after microwave treatment. No hemorrhage or other intra- or post-operative complications was observed. Follow-up observations to January 2006 showed that all the 9 patients survived. One patient survived for 3 years and 5 months, 1 patient survived for 3 years and 8 months, and 1 patient experienced a tumor relapse at 1 year and 4 months and survived for 2 years and 9 months after a Miles procedure. Among 6 patients who survived longer than 5 years, 1 survived for 5 years and 1 month, 1 for 6 years and 3 months, 1 for 6 years and 8 months, 1 for 7 years and 6 months, and 2 for 9 years. Conclusions Surgical indications for microwave coagulation combined with submucous 5-FU injection for rectal cancer included early-stage cancer, lesions located within 7 cm away from the anus, the mass type cancer, tumor diameter at 0.5~3.0 cm or less than one third of the rectum’s circumference, well differentiated tumor, and patient’s strong anus-sparing demand. This method is minimally invasive, safe, reliable, and cost-effective.

Objective To assess the cerebrovascular reactivity (CVR) in health subjects and patients with risk factors by means of transcranial Doppler ultrasonography (TCD) with breath-holding maneuver, and its association with risk factors of cerebrovascular disease.Methods The breath-holding index (BHI), which was the percentage increase in middle cerebral artery(MCA)blood flow velocity and was as index of CVR assessment, was detected during breath-holding by TCD and breath-holding technique in 137 patients with various risk-factors of cerebrovascular disease and 87 normal controls.The regression analysis was done between the CVR and risk factors.Results The mean blood velocity before (Vm) and after holding test (Vm′) were significantly lower in group with age of 20-40 years than that of the age of 41-60 and over 60 years(all P

Objective To explore the changes of cerebral vasoreactivity(CVR) in patients with acute cerebral infarction of various clinical subtypes.Methods The 70 patients with acute cerebral infarction were divided into 3 subtypes:atherothrombotic infarction (AI)group(n=22), lacunar infarction (LI)group(n=33), cardiogenic infarction (CI)group(n=15).The mean blood flow velocity (Vm), pulse index(PI), resistance index(RI) in bilateral middle cerebral artery(MCA) were detected, and breath holding index (BHI) was measured by TCD in these patients through breath holding test. All the data were compared with the health controls. Results Compared with normal control group,the Vm,PI and RI were significantly increased (P0.05). Conclusions There are differents in CVR in patients with acute cerebral infarction of various subtypes. The damage of CVR is more obviously in AI and LI group. There is clinical significance for measurement of CVR to evaluate the haemodynamic changes in various subtype of acute cerebral infarction.

Objective To investigate the feasibility and safety of transabdominal perposterior mediastinum radical operation in the treatment of cardiac carcinoma. Methods Twenty-six cases of cardiac carcinoma invading low esophagus underwent transabdominal posterior mediastinum radical resection. Among them 9 patients received radical proximal gastroesophagectomy, and 17 cases did radical total gastroesophagectomy. Results The procedures were all successful. The mean operation time for total gastrectomy was (189±39) min, proximal subtotal gastrectomy was (153±35) min. The averge blood loss of total gastrectomy was (200±80) ml, proximal subtotal gastrectomy was (168±76) ml. The harvest of celiac lymph nodes were (23.3±7.3), esophageal lymph nodes were (4.1±2.0). Pneumonia was complicated in 4 cases and there was no anastomotic hemorrhage, leakage nor stenosis. All patients were followed up from 5 to 51 months, liver metastasis was found in 4 cases, lung metastasis in 2 patients and death in 1. There was no anastomotic stoma tumor recurrence. Conclusion It was feasible and safe to perform transabdominal perposterior mediastinum radical operation for cardiac carcinoma patients, provided that diaphragms was not involved and tumor invaded esophageal length was less than 5 cm.

Objective To explore an optimal treatment and to study the prognosis related factors of breast cancer patients with local recurrence after mastectomy. Methods From 2002. 7 to 2005. 2, 477female patients with loco-regional recurrence of breast cancer treated in Tianjin Cancer Hospital were analyzed retrospectively. Results In 477 cases, recurrence within 1 year after mastectomy accounted for 26. 2% , recurrence within 2 years accounted for 61. 2%. There were 310 cases with metastasis after local recurrence was diagnosed, accounting for 65.0%. 5-year total survival rate after recurrence is 48.4%.Local control rates varied in subgroups with different recurrence site, clinical subtypes, radiotherapy fields,with or without radiotherapy, surgical resection or excisional biopsy ( P<0. 05 ). There was a statistical difference in distant metastasis rate and 5-year survival rate among subgroups which had different clinical stage of primary tumor, disease-free interval, clinical subtypes or treatment methods ( P<0. 05 ). Simplistic treatment option, late clinical stage of primary tumor and triple-negative breast cancer were the independent factors predicting poor prognosis for recurrent breast cancer ( P<0.05 ). Conclusions Multi-site recurrence and triple-negative breast cancer lead to a poor local control. Local expansion of radiotherapy combined with surgery improves the local control rate. Patients with late clinical stage of primary tumor,recurrence within 2 years, triple-negative breast cancer are likely to have distant metastasis when recurrence is diagnosed. Combined treatment program improves survival rate.

Objective To examine the availability of emergency medical services(EMS) for patients with acute stroke and to investigate influential factors affecting the preference of patients'to EMS.Methods Consecutive information of patients with acute stroke who presented to the emergency department of Zhongnan Hospital of Wuhan University from June 1, 2014 to December 31, 2015 were analyzed.Gender, age of patients, transport modality, risk factors in cerebrovascular diseases, initial symptoms, stroke types, onset and admission time were included to make analysis in retrospective study.The participants were divided into two groups based on the preference of patients, namely EMS group and self-transport group.Wilcoxon rank sum test or Chi-squared test was used to statistical analysis as appropriate.A multiple binary logistic regression was used to determine the relationship between various patient-related factors with probability whether patients chose EMS or not.Results Among the 240 patients, only 29.2%of them asked for the EMS at the onset of symptoms (EMS group, n=70), and the rest patients called for other services(self-transport group, n=170).Logistic regression analysis revealed that the patients with the symptom of altered consciousness or convulsion (95%CI:0.107-0.403,OR=0.208,P<0.01) were more likely to use EMS.The time consumed from onset to visit of patients with acute stroke to emergency physician was significantly shorter in EMS group (M, 60 min vs.180 min,P<0.01).Conclusion The symptom of altered consciousness or convulsion was the independent factor to determine whether patients with acute stroke preferred EMS or not.

Objective To explore the effects of different courses of antenatal dexamethasone on brain development of premature SD rats. Methods The pregnant rats were randomly assigned to 3 groups: 3-dose dexamethasone (group 1), 1-dose dexamethasone group (group 2) and control group. The treated were sacrificed on 19 days of gestation, body and whole brain weight of the offspring rats were measured. Meanwhile the expression o{ neuron specific enolase (NSE) in brains of offspring rats was detected by immunohistochemical staining. The histological structures of baby rat brain were observed under transmission electron microscope. The differences among the three groups were analyzed by ANOVA. Results (1) The body and whole brain weight, the brain and body weight ratio were (1.543±0.052) g, (88.80±7.12) mg, and (5.75±0.38)% in group 1 and (1.584±0.035) g,(98.21±3.71) mg, and (6.20±0.26)% in group 2, both were lower than the control group [(1.696±0.076) g, (111.53±6.29) mg, (6.59±0.48)%], (P<0.01 or P<0.05, respectively). (2) The expression of NSE in cortex in group 1 and 2 were lower than that in control group (0.223±0.054, 0.381±0.041 vs 0.590±0.064) (P<0.01). The expression of NSE in hippocampi in group 1 and 2 were also lower than that in the control group (0.192±0.054, 0.359 ±0.046 vs 0.529±0.068) (P<0.01). (3) Disconnection of nuclei membrane, vacuolization in mitochondria, loss of nueleolus, and disconnection of neurofilaments were observed in the ultrastructure of baby rat brain tissue in both group 1 and 2. Conclusions Antenantal administration of dexamethasone can cause impairment of brain development in premature offspring rats and this might be related to the times of dexamethasone administered.