Objective To explore the clinical value of combined detection of antiperinuclear fac-tor (APF) ,anti-RA keratin antibody (AKA) and anticyclic citrullinated peptide antibody (anti-CCP) in diagnosis and differential diagnosis of rheumatoid arthritis (RA). Methods Totally 119 RA pa-tients,101 non-RA rheumatisants and 39 healthy controls were enrolled in the study. Enzyme linked immunosorbent assay (ELISA) was applied to quantitately detecting anti-CCP antibody; immunofluo-rescence method was applied to quantitately determining AKA and APF. Then the quadruple tabular form was used to calculate the sensitivity and specificity. Results In RA group,the sensitivity of APF, AKA and anti-CCP antibody was 48.8% ,32.3% and 83.5% respectively; the specificity was 92. 2%, 93. 1% and 94.1 % respectively. Conclusion Three autoantibodies,including APF,AKA and anti-CCP antibody have high specificity in early diagnosis of RA. Combined detection of the three antibodies con-tributes to diagnosis and differential diagnosis of rheumatoid arthritis (RA).

Objective To investigate the significance of the expression of endostatin and vascular endothelial growth factor(VEGF)in hepatocellular carcinoma(HCC).Methods The expression of endostatin and VEGF in 46 specimens which were collected at Second Affiliated Hospital of Fnjian Medical University from January 2000 to Apfil 2005 was detected by immunohistochemistry.The relationship between the expression of endostatin and VEGF and the progression of HCC was determined.All data were analyzed via t test,paired t test,Pearson rank correlation coefficient.LSD-t test or Tamhane's-t test.Results The expression of endostatin and VEGF was detected mainly in the cytoplasm of HCC cells and adjacent tissues.The values of mean optical density (MOD)of endostatin in HCC tissue,adjacent tissue and normal liver tissue were 0.11±0.02,0.14±0.0l and 0.09±0.01.respectively,and the values of integrated optical density(IOD)of endostatin in the above mentioned tissues were(1.8±0,2)×10~4,(3.8±2.2)×10~4 and(0.9±0.4)×10~4,respectively.The values of MOD and IOD of endostatin in HCC tissue were significantly lower than those in adjacent tissue(t=2.032,7.927,P＜0.05).The values of MOD of VEGF in HCC tissue,adjacent tissue and normal liver tissue were 0.13±0.02.0.12±0.02 and 0.11±0.02,respectively,and the values of IOD of VEGF were(5.4±3.1)×104,(3.9±2.5)×10~4 and(3.0 ±3.0)×10~4,respectively.The values of MOD and IOD of VEGF in HCC tissue were significantly hisher than those in adjacent tissue(t=5.871,8.723,P<0.05).There was positive correlation between the expression of endostatin and the recurrence of HCC(r=0.669,P<0.05),while VEGF had no influence on the recurrence of HCC(t=0.892,P>0.05).Conclusions Endostatin is mainly expressed in HCC tissue,but the level of its expression is lower in HCC tissue than in adjacent tissue.The expression of VEGF is higher in HCC tissue than in adjaneet tissue.Endostatin,rather than VEGF,may be used as a independent prognostic factor of the prognosis of patients with HCC.

Objective To explore an UPLC method for simultaneous content determination of the five nucleosides (cytidine, uridine, adenine, thymidine and adenosine) in Hedyotis diffusa and its adulterants; To compare the content differences.Methods The analysis was performed on a BEH C18 column (2.1 mm×50 mm, 1.7 μm) by UPLC eluted with acetonitrile and water in gradient mode. The flow rate was 0.5 mL/min; the detection wavelength was set at 254 nm; the column temperature was set at 30℃.Results Five nucleosides have good linear relationship, precision, stability, and repeatability according to the requirements of the methodology determination. The recoveries were among 98.7%–101.5%. Five nucleosides in Hedyotis diffusa and its adulterants from different areas were determined by the UPLC method.Conclusion The method is certified to be simple, rapid, accurate and reliable, which can be used for the determination of nucleosides in Hedyotis diffusa and its adulterants.

Carotid artery calcification is a calcium deposition on arterial wals. It has a great clinical significance when it occurs within atherosclerotic plaques, which is a marker of the progressive atherosclerosis. In recent years, the studies on the mechanism of carotid artery calcification and imaging detection methods are continuously advancing and being updated. In addition, the correlation between carotid plaque calcification and ischemic cerebrovascular disease and the effect on its therapeutic decisions are also the research foci. However, there have been controversies about the advantages and disadvantages of carotid artery calcification. Some researchers believe that carotid artery calcifications are a protective factor, but others believe that they may promote the plaque vulnerability. This article reviews the recent progress in research on carotid artery calcification from the above aspects.

Objective To investigate the clinical value of classic intrafascial supracervical hysterectomy(CISH) by including the clipping of the uterine artery.Methods A total of 60 cases of benign uterine diseases were included in the study.After the uterine artery had been dissected and clipped on both sides under laparoscope,classic intrafascial supracervical hysterectomy was performed.Results All the operations were performed successfully under laparoscope.No conversions to open surgery were needed.Operating complications happened in no case.The operating time was 72~186 min(91.4?26.3 min),the amount of blood loss was 50~150 ml(76.5?20.6 ml),the time to postoperative gastrointestinal function recovery was 18~30 h(22.7?5.8 h),and the volume of pelvic drainage within 24 hours,50~160 ml(80.5?31.8) ml.Postoperative body temperature was elevated to 38.5 ℃ in 2 cases,the postoperative pyrexia rate being 3.3%.The length of postoperative hospital stay was 4~7 d.Follow-up for 6~18 months(10.6?4.2 months) in the 60 cases showed 3 cases of small amount of vaginal bleeding at 1~3 months,which were cured with the use of antibiotics and hemostatics for 5~7 d.Conclusions Classic intrafascial supracervical hysterectomy by including the clipping of the uterine artery is a safe and effective improvement to CISH technique.

Objective To investigate the clinical efficacy of total laparoscopic hysterectomy(TLH) with separating and blocking uterine arteries.Methods From January 2004 to June 2006,68 cases of uterine benign diseases underwent TLH by blocking uterine arteries after separating and clipping uterine arteries with Titanic clip.Results All operations were performed successfully without conversion to open surgery and complications.1 patient,who had twice gastrohysterectomy histories,underwent bipolar coagulating uterine arteries as to the failure of separating bilateral uterine arteries.Pelvic adhesion release was performed in 18 cases,unilateral or bilateral adnexectomy in 14 cases,oophorocystectomy in 8 cases,appendectomy in 1 case,and cholecystectomy in 1 case simultaneously.The operation time was 90-185 min,(112.6?27.5)min.The time of separating uterine artery in one side was 3-15 min,(5.2?3.4)min.The intraoperative blood loss was 50-150 ml,(86.5?39.6)ml.The time to first bowel movement was 18-48 h,(27.3?4.8)h.The rate of postoperative pyrexia was 4.4%(3/68),and the hospital stay was 4-7 d,(5.1?1.8) d.A follow-up period of 2-6 months,(3.5?1.6) months,showed 3 cases of vaginal dropping hemorrhage 1-2 months after operation,which was cured with the use of antibiotics and hemostatics for 5-7 d.Conclusions TLH with separating and blocking uterine arteries is a safe,effective and feasible procedure with less complication,so it is worthy of being recommended.

Objective To evaluate the diagnostic value of galactomannan(GM) detection for invasive aspergillosis infections in pediatric patients, a Meta-analysis was performed.Methods According to selection criteria, studies indexed by PubMed,EMBASE,Medline,CNKI and Wanfang Data on GM testing in pediatric aspergillosis were included from January 2001 to November 2012. The methodological quality was assessed by QUADAS, sources of heterogeneity investigated, pooled effect quantities evaluated, and summary receiver operative curves(ROC) and subgroup analysis performed.Stata12.0 was used to analyze diagnostic parameters, such as, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve(AUC). Results Thirteen articles with 16 sets of data were included.The weighted sensitivity and specificity with 95% confidence interval were 0.71(0.60-0.79)and 0.94(0.89-0.96), respectively.Under different cut-off values, sensitivities of GM assay in diagnosis of pediatric aspergillosis were 0.71(0.54-0.84) for 0.5, 0.77(0.64-0.87) for 0.8, 0.72(0.58-0.84) for 1.0 and 0.59(0.39-0.76) for 1.5, and its responding specificities were 0.94(0.89-0.97), 0.89(0.82-0.93), 0.89(0.81-0.94) and 0.91(0.88-0.94).Conclusion Under the cut-off value of 0.8, the GM assay is a useful method in the detection of pediatric invasive aspergillosis.

N 6-methyladenosine (m 6A) is the most abundant RNA base modification in mammals, especially in eukaryotic messenger RNA (mRNA). N 6-methyladenosine modification can regulate RNA splicing, translocation, stability and ultimately affect protein synthesis. m 6A modification is catalyzed by RNA writers, reduced by erasers and also be recognized by readers. Abnormal changes ofm 6A levels are closely related to tumor occurrence and development, including proliferation, growth, invasion and metastasis. In the process of tumor radiotherapy, m 6A modification affects the efficacy of radiotherapy by affecting DNA damage, tumor stem cell generation and tumor cell radiation sensitivity. This article reviews the role of m 6A-modified epigenetic regulation in malignant tumors and the research progress of its mechanism in tumor radiotherapy, in order to provide new ideas for the development of clinical tumor molecular targeted therapies and radiosensitizers.

Objective To report the surgical approach for the treatment of giant or extensive skin lesions due to the infection of human papilloma virus (HPV). Method Surgical treatment was performed for 10 patients with verruca vulgris, 20 with condyloma acuminatum, and 8 with epidermodyplasia verruciformis, whose giant or extensive lesions were poorly responsive to routine non-surgical therapy. Results Recurrence of lesions was found in 2 of 10 patients with verruca vulgris and 5 of 20 condyloma acuminatum in 6 months after operation, with a total recurrent rate of 25%. The extensive skin lesions were removed and the functions of affected limbs were recovered in patients with epidermodyplasia verruciformis after operation, however, the long-term topical retinoids was needed to control the recurrence of the lesions. Conclusion Surgical approach is effective for the treatment of the giant or extensive skin lesions due to HPV infection.