0.05).Conclusion There are hapatic and renal disease,craniocerebral disease,wound,toxicaion with hypouricemia,the clinical assay should be paid more attention.

Objective To study the relationship between age with sex and sero-uric acid concentration in Shanwei,and to found the range of criterion of sero-uric scid of themself in all area's laboratory.Methods The specimen of health adults of 789 patients were detected by urate oxidase-indirect peroxidase couple.Results The serum uric acid concentration of males were (341.2?70.3)?mol/L and females (282.3?61.3)?mol/L.It had approached the level of occidend.The difference was very significant compared with males and females in the same age(P

Objective To investigate the influence of proinflammatory factor interleukin-18(IL-18) on vein endothelial cell function by activating NF-κB mediated cell signal pathway and its association with deep vein thrombosis(DVT).Methods Recombinant human IL-18 was used to act on in vitro cultured human umbilical vein endothelial cell(HUVECs).The NF-κB activation inhibitor was used to conduct interference.The detection measures of real time fluorescence quantitative PCR,Western blot,immunofluorescence and flow cytometry were used to verify whether IL-18 affect the expression of endothelial cellular function markers such as HUVECs normal statusand vWF,P-selectin and tissue plasminogen activator(t-PA) by activating NF-κB mediated cell signal pathway.Moreover the mechanism of IL-18 participating in the DVT was performed the comprehensive analysis by combining with previous study.Results IL-18 could activate NF-κB in endothelial cell,increased the p65 expression in nucleus,decreased the intracellular IκBα expression and significantly increased early apoptosis cells in HUVECs;adding QNZ(EVP4593) could significantly inhibit the activation effect of IL-18 on NF-κB,the occurrence of cellular injury and apoptosis was significantly reduced;IL-18 could promote the abnormal expression of DVT related endothelial cell markers vWF,P-selectin and t-PA (P<0.05).But various markers could recover conventional expression after inhibiting NF-κB activation.Conclusion The interaction between Il-18 and NF-κB causes the abnormality of HUVECs growth status and function,which may be the DVT onset related pathogenic mechanism.

Objective To evaluate Jiangxia umbilical therapy on the quality of life in patients with gastric carcinoma chemotherapy after surgery.Methods Patients with gastric carcinoma chemotherapy after surgery in the Third Affiliated Hospital of Sun Yat-Sen University from January 2016 to December 2016 were chosen as the research subjects.According to the time of chemotherapy,the patients were divided into two groups.Patients with gastric carcinoma chemotherapy in hospital from January 2016 to June 2016 were chosen as control group,while patients in hospital from July 2016 to December 2016 were chosen as observation group.Before chemotherapy,the control group was given tropisetron hydrochloride intravenous injection,while the observation group added Jiangxia umbilical on the basis of this.Nausea and vomiting in the two groups were observed after treatment.Quality of Life Questionnaire of Stomach 22 was applied to analyze and compare the patients' quality of life.Results The incidence rate of anti nausea in the observation group was 88.10％,which in the control group was 61.90％,the difference was statistically significant (x2 =9.571,P ＜ 0.05).The overall quality of life in observation group was significantly better than that in the control group [(20.34 ±:5.84) points vs.(14.32 ± 5.97) points,t =8.686,P ＜ 0.01].The scores in the observation group on the quality of life in the aspects of total score,anxiety scale,reflux scale,eating restricted scale,dry mouth,tastes changing had statistically significant differences compared with the indicators in the control group (all P ＜ 0.05).Conclusion Jiangxia umbilical therapy can not only relieve the chemotherapy-induced nausea and vomiting of patients with gastric carcinoma chemotherapy after surgery,but also can improve their quality of life.

Objective To investigate the practice effect of WeChat software on extended care for patients with anterior resection syndrome. Methods From August 2014 to August 2015, 50 patients with anterior resection syndrome were chosen as control group. From September 2015 to August 2016, 50 patients with anterior resection syndrome were chosen as experimental group. Patients in experimental group could use WeChat software independently. Control group got extended care by telephone, while experimental group was carried out through WeChat platform. They were followed up for 6 months. WeChat software offered patients professional guidance on evaluation and exercise methods of defecation function by video and text with some figures. The questions from patients were answered through WeChat software during followed up. Results The defecation function after 1 month of surgery for patients with excellent, good, average, poor was 15, 20, 12, 3 cases respectively in the experimental group, and 9, 15, 19, 7 cases respectively in the control group. The defecation function after 3 month of surgery for patients with excellent, good, average, poor was 19, 21, 8, 2 cases respectively in the experimental group, and 12, 18, 17, 3 cases respectively in the control group. The difference of the defecation function after 1,3 months of surgery were statistically significant (χ2=8.395, 8.251, P<0.05). But the difference of the defecation function after 6 months of surgery had no statistical significance (χ2=7.505, P>0.05). The compliance of medication, diet and rehabilitation exercise, regular review after 6 months of surgery for patients was (2.14 ± 0.72), (7.21 ± 1.63), (11.20 ± 0.63), (5.04 ± 0.78) points respectively in the experimental group, and (1.37 ± 0.58), (5.72 ± 1.32),(9.75 ± 1.56),(4.72 ± 0.43)points respectively in the control group, and the differences were statistically significant (t=2.68-5.75, P< 0.01).Conclusion WeChat software can improve defecation function and treatment compliance, thus greatly improve the quality of life of patients with mid-low rectal cancer.

Jaundice is frequent clinic symptoms with high incidence especially among the critical patients. The sepsis complicated with jaundice has drawn more and more consideration. However, the pathogenesis about sepsis complicated with jaundice is not confirmed and it is sometimes identified incorrectly as cholestatic jaundice. This article summarises the pathogenesis and elucidate the management about sepsis complicated with jaundice.

Objective To investigate the atypical CT ,MRI findings of pancreatic neuroendocrine tumors (PanNETs) ,in order to improve diagnosis .Methods The clinical ,imaging and pathological data of 6 patients with PanNETs confirmed by pathology were analyzed retrospectively .Results In all 6 cases ,2 lesions were located in the pancreatic head ,3 lesions in the pancreatic body ,and 1 lesion in the pancreatic tail .There were 2 functional PanNETs with an average size of 2 .1 cm × 2 .6 cm ,which showed homogeneous density or signal .There were 4 nonfunctional PanNETs with an average size of 2 .7 cm × 4 .3 cm ,one of which had calcification ,and two of which had obviously cystic change ,including intracapsular bleeding in one case .Contrast‐enhanced examinations showed that all 6 lesions had mild or moderate enhancement .Three lesions were manifested as relatively intense enhancement in the arterial and portal venous phase ,but decreased enhancement in the delayed phase ,including annular envelope enhancement in one case .Two le‐sions were manifested as progressive enhancement .The last case was manifested as inwardly filled enhancement .Three lesions had unclear boundaries ,while one lesion had splenic vein invasion .Two cases accompanied with mild expansion of the common bile duct or pancreatic duct .Conclusion PanNETs can be ma+nifested as atypical findings such as obviously cystic changes ,and(or) mild to moderate enhancement .It is suggested that the atypical imaging findings of PanNETs should be recognized well to improve the diag‐nostic accuracy .

Objective To investigate the value of CT spectral imaging in differential diagnosis of atypical pheochromocytoma and adrenal adenoma.Methods The energy spectrum CT data of 13 cases of atypical pheochromocytoma and 15 cases of adrenal cortical adenoma confirmed by surgery pathology were retrospectively analyzed.All images processed by spectrum software.The CT value of different energy levels (40-140 keV) in arterial,venous and delayed phase,energy spectrum curve and spectrum curve type,base material of concentration (water-iodine,grease-iodine,blood-iodine) were obtained,and the CT value of different energy were standardize in the same period.Data were compared with samples t test.Results For arterial phase,the standardization CT values of pheochromocytoma on monochromatic images of 40 keV,70 keV to 140 keV had statistical difference with those of adenoma (all P＜0.05).For venous phase,the standardization CT values of pheochromocytoma on monochromatic images of 70 keV to 140 keV had statistical difference with those of adenoma (all P＜0.05).For delayed phase,the standardization CT values of the two tumors on monochromatic image of 40 keV to 140 keV had significant difference (all P＜0.05).Both the energy spectrum of the three periods of type curve was falling,pheochromocytoma always located above compared with adenoma.The standardization concentration of base materials including water (iodine),fat (iodine) and blood (iodine) of pheochromocytoma were higher than those of adenoma in three phases (all P＜0.001).The standardization concentration of base materials including iodine (water),iodine (fat) and iodine (blood) had no significant difference in three phases between pheochromocytoma and adenoma (all P＞ 0.05).Conclusion Atypical pheochromocytoma and adrenal adenoma have different spectral curve and spectrum characteristics of the material content.Spectral CT imaging provides a method of multiple parameters to identify atypical adrenal pheochromocytoma and adenoma.

Objective To explore the diagnositic value of dual-phase contrast enhancement CT combined with virtual non-enhanced images by dual-energy CT in clear cell renal cell carcinoma.Methods Sixty patients who were suspected of clear cell renal cell carcinoma underwent non-enhanced CT and contrast enhancement CT of early interface-phase between cortex -medulla and parenchymal phase on a dual-energy CT.The true non-enhanced kidney CT(TNCT) was performed in a single-energy acquisition mode,but the dual-phase contrast enhancement CT were performed in a dual-energy mode of 80 kV and 140 kV respectively.The virtual non-enhanced CT ( VNCT ) images were derived from the data of early interfacephase using liver virtual non-contrast software.The diagnosises according to VNCT combined dual-phase contrast enhancement CT and dual-phase contrast enhancement CT only were made respeetively and compared with x2 test.Between the true non-contrast CT and the virtual non-contrast CT,the image quality was compared with Wilcoxon test ; The radiation dose of volume CT dose index ( CTDlvol ) and dose length product(DLP) in a single-phase and total examination,the mean CT HU values of the tumours werecompared with t test.Results The accuracy of VNCT combined dual-phase contrast enhancement CT was higher than that of dual-phase contrast enhancement CT only [93.3％ ( 56/60 ) vs.78.3％ ( 47/60 ) ; x2 =5.6,P ＜0.05].The detective ability (score) of VNCT was near to that of TNCT and the difference was not obvious( Z =0.00,P ＞ 0.05 ). The radiation dose of volume CT dose index ( CTDIvol ) and dose length product(DLP) in a single phase and total examination of VNCT[(8.85 ± 1.28) mGy,(196.45 ±21.12) mGy·cm,(17.69±2.35) mGy,(392.90±42.25) mGy · cm] were lower than that of TNCT [( 10.20 ± 1.44 ) mGy,( 218.29 ± 29.60 ) mGy · cm,( 30.61 ± 3.27 ) mGy and ( 654.86 ± 88.81 ) mGy ·cm],t =4.21,3.58,23.63,16.12 respectively,P ＜0.05.The mean CT HU values of tumours on VNCT images was higher than that on TNCT images and the difference was significant [(39.37 ± 6.35 ) vs.(34.94 ± 7.00 )HU,t =- 14.39,P ＜ 0.05].Conclusions The diagnositic value of dual-phase contrast enhancement CT combined virtual non-enhanced CT by dual-energy CT for clear cell renal cell carcinoma was obvious,most tumours can be diagnosed correctly,and the radiate dose can be decreased obviously,the normal single-energy non-enhanced and contrast enhancement CT might be replaced in the future.

Objective To evaluate the expression and clinical significance of plasma circulating microRNA-23b in patients with myasthenia gravis (MG).Methods Plasma samples from 32 MG patients and 32 healthy people were collected in the Second Affiliated Hospital of Harbin Medical University from October 2015 to August 2016. Expression of microRNA-23b was detected by quantitative reverse transcription polymerase chain reaction .The relationship among microRNA-23b expression level, clinical features and quantitative myasthenia gravis score ( QMG ) was analyzed. Results The expression of circulating microRNA-23b in plasma was significantly higher in MG patients (4.587 (3.654, 5.423)) compared with control group (2.889 (1.968, 4.027), Z=-4.169, P<0.01), meanwhile it was positively related to QMG (r=0.661,P<0.01).But the expression of circulating microRNA-23b had no statistically significant difference in MG subgroups .Conclusion Plasma circulating microRNA-23b is highly expressed in MG and has positive correlation with MG severity .