Objective To investigate the effects of liver function and tumor markers by nucleoside analogues Entecavir on patients with liver cirrhosis after hepatitis B.Methods 90 patients with liver cirrhosis after hepatitis B were selected, according to the different drugs were divided into experimental group and control group.Liver function and levels of tumor markers were compared after experiment.Results Two groups of patients with male to female ratio, average age, course of disease, no significant difference in general data of hepatitis B virus DNA content, comparable (P>0.05);Compared with the control group, the experimental group HBV DNA level is low, the negative rate was significantly higher (P<0.05);Compared with the control group, the experimental group ALT, AST and TBiL levels were significantly increased(P<0.05), ChE, AlB were significantly decreased (P<0.05);Compared with the control group, the experimental group CEA, AFP, CA125 and lower CA199 levels (P<0.05).Conclusion Nucleoside drugs can significantly improve liver function in patients with liver cirrhosis after hepatitis Band tumor markers indicators, and it is significance for treatment of liver cirrhosis after hepatitis.

Objective:To evaluate the in vitro release behavior of doxorubicin(Dox)-loaded microspheres and the stability of Dox during encapsulation process and in vitro release.Methods: Dox-loaded microspheres were prepared by double emulsion(W/O/W) method with poly(lactic-co-glycolic acid)(PLGA) as the carrier material.The physical and chemical characteristics of microspheres,including the mean diameter,morphology,drug entrapment efficiency and loading rate,were evaluated.The in vitro release behavior and its influencing factors were determined by ultraviolet spectrophotometry.Dox stability was evaluated by HPLC method during the encapsulation process and in vitro release.Results: The prepared microspheres had a complete spheric shape and dispersive quality.The mean diameter of the microspheres was 85 ?m;the drug entrapment efficiency was 95.1%;and the loading rate was 14.8%.Releasing rate of the microspheres slowed down with the increase of PLGA concentration and the decrease of W/O value.The encapsulation process had no obvious effect on the stability of Dox,while Dox degraded during in vitro release as the prolongation of time.On day 10,the peak area of degraded material accounted for 2.46%.Conclusion: Dox can be encapsulated in the microspheres by double emulsion method and different release rates of Dox can be achieved by adjusting PLGA concentration and W/O volume ratio.

To develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of epirubicin hydrochloride (EPI) in rat plasma, daunorubicin hydrochloride was used as internal standard. The plasma samples were deproteinated with methanol, and separation was performed on a reversed-phase CAPCELL PAK C18 column (3.0 mm x 50 mm, 3 microm). The mobile phase contained methanol-0.1% formic acid (80:20). Detection was carried out by multiple reaction monitoring on a HP1200-6410 QQQ LC/MS system. Different preparations of EPI solution, EPI-LIP (EPI-liposome) and EPI-LTSL (EPI-thermosensitive liposome) was administered in rats by i.v with the same dosage (12 mg kg(-1)). The pharmacokinetic model and parameters were fitted and calculated by the DAS ver2.0 software. The calibration curve was linear in the range of 0.01-50 microg mL(-1). The limit of quantification was 0.01 microg mL(-1). RSDs of intra- and interbatch precisions were all less than 11.9%. The average extract recovery was 89.3% and 92.1%, respectively. The pharmacokinetics of EPI in rats with all preparations were fitted to three compartments, which all fast distributed and slowly eliminated. The t1/2 alpha, t1/2 beta, t1/2 gamma, AUC(0-infinity), and MRT(0-infinity) of EPI-LTSL group were 7.5, 1.3, 12.6, 12.9, 3.7 times those of EPI solution group; and 1.6, 1.4, 12.3, 2.9, 2.6 times those of EPI-LIP group. Moreover, the CL of the latter two groups was about 13.4 times of the former EPI-LTSL group. EPI-LTSL can significantly improve AUC and prolong the circulation time of EPI in rat plasma.

BACKGROUND:Because of osteoporosis, short-segment transpedicular fixation or screw-rod system fixation is prone to screw loosening depending on its poor anti-pul-out strength in patients with thoracolumbar fracture with ankylosing spondylitis.
OBJECTIVE:To probe the clinic outcomes of multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis.
METHODS:Eleven patients with ankylosing spondylitis combined with thoracolumbar fracture in the Fourth Department of Orthopedics, Meizhou Hospital, Sun Yat-sen University, China from January 2009 to December 2012 were selected. Al the patients underwent posterior reduction and multi-segment transpedicle spinal fixation, among whom, six cases were subjected to internal fixation through the pedicle of fractured vertebra.
RESULTS AND CONCLUSION:Al of the 11 patients were fol owed up for 13 to 36 months. Solid bone healing was achieved in al of the patients, and there were no complications related to the internal fixation systems such as loosening or breakage. Three cases of spinal cord injury achieved Frankel’s class E from class C recovery. Lumbodorsal pain rate achieved 100%according to the Japanese Orthopaedic Association scoring. Results confirmed that it is effective to treat thoracolumbar fractures with ankylosing spondylitis by posterior reduction and multi-segment transpedicle spinal fixation. Strong internal fixation and fracture union can be achieved by operation.

Objective To evaluate the diagnostic value of the early rheumatoid arthritis (RA) classification criteria for early RA and to assess the clinical efficacy of knee arthroscopic synovectomy for RA.Methods A total of 62 patients who had arthritic complaints with disease duration less than one year were treated with knee arthroscopic synovectomy.Patients were diagnosed as RA confirmed by changes of synoviomorphous under arthroscopy,synovial biopsy,immunological biochemical laboratory and MRI,and compared with the preoperative ERA diagnosis.The efficacy was assessed at the third months and more than 12 months after operation,including Health Assessment Questionnaire (HAQ),Lysholm score,laboratory parameters of erythrocyte sedi-mentation rate (ESR) and C-reactive protein (CRP).Results The sensitivity and specificity in the early RA classification criteria for RA diagnosis were 81.58％ and 91.67％.38 patients diagnosed as RA and the remaining 24 patients were significantly improved of HAQ,Lysholm score,ESR,CRP compared with preoperation,showed statistical difference (P ＜ 0.01).There were still statistical differences between the follow-up results of the group of patients with RA in different period after operation (P ＜ 0.01).Conclusion The early RA classification criteria is worthy of clinical application,because it has the advantages of simple,practical,and is beneficial to early diagnosis of RA.The early RA patients should be treated with knee arthroscopic synovectomy as far as possible.It can improve not only the knee function,but also the general symptoms,and it can interrupt the RA pathological process,effective maintain curative effect after operation.

OBJECTIVE To clarify the features of nosocomial infections for patients with multiple myeloma(MM).METHODS One hundred and seventy eight cases of MM treated in our hospital from Oct 1982 to Dec 2006 were analyzed retrospectively.RESULTS Eighty five patients(47.8%) suffered from nosocomial infections.The nosocomial infection took place more frequently on respiratory tract.Elder,granulocytopenia,hypoproteinemia,severe anemia,and diabetes were the risk factors.Totally 91 pathogens were isolated.Gram-negative bacilli accounted for 45.1%,and were the major pathogens.Fungi accounted for 37.4% and Gram-positives accounted for 17.6%.The ESBLs producing strains accounted for 31.6% in Klebsiella pneumoniae and Escherichia coli.Vancomycin resistant strains were found.The top one of fungi presented organism was the Candida albicans.CONCLUSIONS Nosocomial infections for patients with multiple myeloma has a high incidence.There are many risk factors.The resistance of commonly encountered bacteria to antimicrobial agents is a serious problem.Immunity protection and the rational use of antimicrobial agents should be emphasized.

Objective To explore the clinical value of magnetic resonance imaging( MRI) in the diagnosis and classification of perianal abscess and anal fistula.Methods Eighty patients with suspected perianal abscess and anal fistula were selected in Yuyao People＇s Hospital from May 2016 to December 2017.They were divided into general examination group and MRI group by random number table,with 40 cases in each group. The general examination group underwent ultrasound examination,and the MRI group underwent MRI examination.The detection rate of MRI examination for various types of perianal abscess and anal fistula was analyzed based on the results of operation. Results In the general examination group, the diagnostic accuracy of anal fistula supervisor, anal fistula internal orifice,perianal abscess and anal fistula branch were 65.0% (26/40),70.0% (28/40),57.5% (23/40) and 52.5% (21/40),respectively,which in the MRI group were 92.5% (37/40),77.5% (31/40),87.5% (35/40) and 95.0% (38/40),respectively.There were statistically significant differences in diagnostic accuracy of anal fistula supervisor, perianal abscess and anal fistula branch between the two groups ( χ2 =9.054,7.116,8.865, all P <0.05). The effective rate of operation in the MRI group was 67.5% (27/40),which was significantly higher than that in the general examination group [67.5% (27/40)],the difference was statistically significant(χ2 =9.935,P<0.01). Conclusion Using MRI to diagnose perianal abscess and anal fistula can accurately judge the number,involvement range,specific location and surrounding structure of the abscess and anal fistula,and has important value for clinical treatment and prognosis.

Objective To establish a quick method to identify BMSC by fast violet B salt staining and evaluate the clinic value. Methods Smears of separated and cultured BMSC, bone marrow, pleural and ascitic fluids were made, then the staining of fast violet B salt was performed. The BMSC in aplastic anemia (AA), high hyperplasia and normal groups were counted and compared with each other. Meanwhile, the diagnostic value of this method to AA was evaluated. Results The cytoplasm of BMSC presented mauve, while the nucleus were negative, other cells such as myelocytes, nucleated erythrocytes, megakaryocytes, monocytes, macrophages, lymphocytes and plasmacytes were negative. The count of BMSC in AA, high hyperplasia and normal group was 1.07 ± 0. 29, 2. 26 ± 0. 37 and 1.58±0. 33, respectively. Significant differences were found between AA and high hyperplasia groups, AA and normal groups, high hyperplasia and normal groups, respectively (P < 0.01). The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of this method for diagnosis of AA were 90%, 93%, 12. 86 and 0. 11,respectively. Conclusions The fast violet B salt staining is simple and convenient. It could be used to identify BMSC and play an important role in judging the hyperplasia extent and differentiation of AA.

Objective To investigate the frequeney of four single nucleotide polymorphism (SNP) sites (rs17300539, rs12495941, rs2241766 and rs1501299) of adiponectin gene (ADIPOQ) and to elucidate its role in the pathogenesis of polycystic ovary syndrome (PCOS).Methods A total of 207 women with PCOS and 192 controls were recruited.Four ml whole-blood samples were collected in tubes containing ethylene diamine tetraacetic acid (EDTA) by peripheral venous puncture.Genomic DNA was extracted using a QIAamp DNA mini kit.Four SNP sites (rs17300539, rs12495941, rs2241766 and rs1501299) of ADIPOQ were amplified by PCR and then directly sequenced to screen variants.Results (1) The genotype frequencies of AA of rs17300539 in PCOS was significantly higher than controls [57.5％ (119/207) versus 48.4％ (93/192), P＜0.05].The genotype frequencies of AA of rs1501299 in PCOS was significantly lower than controls [4.8％ (10/207) versus 11.5％ (22/192), P＜0.05].While no significant differences were found in rs2241766 and rs12495941 (P＞0.05).(2) The allele A of rs17300539 [75.8％ (314/414)] and allele C frequeneies of rs1501299 [76.3％ (316/414)] in PCOS were significantly higher than controls [67.7％ (260/ 384), 69.0％ (265/384), respectively;all P＜0.05].While no significant differences were found in rs2241766 and rs12495941 (P＞0.05).(3) Further analysis we found rs17300539 AA genotypes had an increased risk for PCOS compared with GG genotype (OR=2.670, P=0.009), rs1501299 CC genotype had an increased risk for PCOS compared with AA genotypes (OR=2.756, P=0.012);and the difference remained significantly after adjustment for age, testosterone and body mass index (P＜0.05).Conclusions No signifi cant differences were observed in genotype and allele frequencies between PCOS and controls for rs2241766 and rs12495941.However, we observed an association between rs17300539, rs1501299 and PCOS.rs17300539 and rs1501299 of ADIPOQ perhaps are the susceptibility gene locus of PCOS.

Objective To explore the characteristics of ventilatory efficiency and exercise capacity during cardiopulmonary exercise testing in patients with idiopathic pulmonary fibrosis (IPF).Methods Pulmonary function test,arterial blood gas analysis and cardiopulmonary exercise testing were performed in 28 IPF patients (IPF group) from April 2012 to April 2013 and 28 healthy volunteers (control group).And the relevant parameters were measured and compared.Results No significant differences existed in age [(57.8 ±9.8) vs.(59.2 ±5.5) years],gender or body mass index (BMI) [(23.8 ±2.7) vs.(25.0 ± 2.8) kg/m2,P ＞ 0.05].The paramneters of pulmonary function test,such as forced vital capacity ％ predicted (74.8 ± 14.6 vs.101.8 ± 10.8),forced expiratory volume in 1 second ％ predicted (73.8 ± 14.6 vs.97.0 ± 10.1),maximum voluntary ventilation ％ predicted (77.5 ± 14.9 vs.95.4 ±24.5),total lung capacity ％ predicted (75.6 ± 12.4 vs.99.8 ± 5.4),residual volume ％ predicted (80.7 ± 15.4 vs.95.8 ± 11.3),diffusing capacity of lung for carbon monoxide ％ predicted (66.2 ± 13.7 vs.103.2 ± 17.3) in the IPF group,were significantly lower than those of the control group (P ＜ 0.01).The parameters of arterial blood gas analysis,such as PaO2 [(72.7 ± 7.3) vs.(92.6 ± 3.8) mmHg] and SaO2 (94.3 ± 2.1 vs.98.3 ± 0.7),were lower than those of the control group (P ＜ 0.01).Thus P(A-a) O2 in the IPF group was higher than that in the control group (33.3 ± 5.7 vs.17.8 ± 1.9,P ＜0.01).These results strongly suggested that IPF group had restrictive ventilatory dysfunction and impaired gas exchange.The IPF patients had higher VE/VCO2-slope (37.4 ± 5.3 vs.25.7 ± 2.5,P ＜ 0.01) and lowest VE/VCO2 (39.2 ±6.7 vs.30.6 ± 2.7,P ＜ 0.01) than the controls; VE/VCO2 and VD/VT during every period were significantly higher in the IPF group than those in the control group (P ＜ 0.01) ; during peak exercise,peakLoad％pred (70.4 ±±29.9 vs.104.8 ±29.7,P ＜0.01) and peakVO2％pred (68.7 ±29.8 vs.98.7 ±36.4,P =0.001) were significantly lower in the IPF group than those in the control group.In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with DLCO％pred (r=-0.589,P ＜0.01; r=-0.481,P＜0.05; r=-0.527,P＜0.05).In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with peakVO2％ pred (r =-0.548,P ＜ 0.05 ; r =-0.539,P ＜ 0.05 ; r =-0.564,P ＜ 0.05).So the exercise tolerance and ventilation efficiency of the IPF group decreased significantly.Conclusion Cardiopulmonary exercise testing reveals that the ventilation efficiency of IPF patients decreases significantly so as to seriously affect their exercise tolerance