Objective To explore the relationship between serum levels of procalcition (PCT),CRP and pneumonia,and its clinical significance.Methods Serum levels of PCT and CRP were measured with electrochemiluminescence and immunoturbidimetry respectively in 418 children with pneumonia and 120 healthy children.Results Serum levels of PCT and CRP in pediatric pneumonia group were significantly higher than those of control group(F =24.13,8.73,all P ＜ 0.05).The levels of PCT and CRP in the bacterial pneumonia group were higher than those of viral pneumonia group (t =23.58,38.77,all P ＜ 0.05).The CRP level of mycoplasmal pneumonia group,was higher than that of the viral pneumonia group (t =38.37,P ＜ 0.05),while the serum PCT level between the viral pneumonia group and mycoplasmal pneumonia group had no significant difference (t =3.80,P ＞ 0.05).The serum PCT and CRP levels were gradually increased with the aggravation of the pneumonia.Conclusion Determination of serum PCT and CRP can be used as a conventional index for early diagnosis and differential diagnosis of pediatric pneumonia.In addition,the serum levels of PCT and CRP gradually increased with the increase of the severity,its level can help to assess the severity of pneumonia.

Melanoma antigen A is a kind of rumor-associated antigen,which expresses in various types of hunman malignant tumor tissues especially in melanoma.Hepatocellular carcinoma (HCC) is a kind of malignant epithelial tumor with high incidence which occurs in liver.Searching for effective diagnosis and treatment methods of it become a pressing task.It is confirmed that MAGE-A gene is highly expressed in HCC tissues which has great significance to the diagnosis,treatment and prognosis for HCC.

Objective To identify whether abnormal clinical manifestations of dysphagia in stroke patients could predict associated imaging abnormalities. Methods Clinical evaluations and videofluoroscopy were performed on 56 consecutive cases of stroke. The clinical and image manifestations of dysphagia were observed and analyzed u-sing logistic regression analysis. Results A bolus leaking from the mouth was found (P =0.037) to predict abnormal lip closure. Raising the head when swallowing (P =0.010) and dysarthria (P =0.025) were found to predict reduced tongue movement. Exertion in swallowing (P = 0.016) could predict poor laryngeal elevation. Abnormal la-ryngeal elevation (P =0.024) and reduced or absent gag reflex (P =0.005) were found to predict insufficient epiglottis tilt down. Coughing caused by swallowing could predict incomplete vocal fold closure (P =0.011) and aspiration (P = 0.042). Conclusion Videofluoroscopic manifestations could be predicted to some extend by some clinical swallowing abnormalities, which could increase the accuracy of clinical evaluation and help in the management of dysphagia in those who could not endure videofluoroscopy.

Objective Videofluoroscopy could identify the pathophysiologic changes of swallowing and be help to make management plan. The study was to identify image manifestation and characteristics of dysphagia in stroke under X-ray. Methods Videofluoroscopy were performed in 56 stroke inpatients and 30 healthy volunteers who drunk 1, 3 and 5 ml barium with viscosity of 60%w/v, 180%w/v and ate half piece of cake smeared with barium. Abnormal swallowing and quantitative measurements in antero-posterior and lateral position were recorded. Chi square test and Logistic regression analysis were used to identify abnormal swallowing associated with accidental aspiration. Rank test and t test were used to analysis the difference of quantitative measurements between control and accidental aspiration group. Results All the swallowing apparatus could be injured after stroke which led to a variety of abnormal oral and pharyngeal swallowing including decreased tongue and palate motility, insufficient glottis closure, delayed swallowing, accidental aspiration etc. All patients presented abnormality in pharyngeal phase and 46 in oral phase. Compared with that of volunteers, height and velocity of larynx elevation decreased, opening width of cricopharyngeal muscle reduced and swallowing latency prolonged in dysphagia patients. Accidental aspiration was seen in 34 patients, of whom 14 patients presented silent aspiration. Statistic analysis showed that decreased tongue movement(P=0.021), poor tongue-hard palate contact (P=0.021), insufficient glottis closure(P=0.011), decreased height and velocity of larynx elevation(P=0.003), delayed swallowing (P=0.001) and penetration (P=0.000) were associated with accidental aspiration. Conclusions Stroke may injure all the swallowing apparatus, more frequently in pharyngeal phase. Tongue weakness, insufficient glottis closure, poor larynx elevation, delayed swallowing and penetration are associated with accidental aspiration.

In clinical practice,regional portal hypertension is infrequent,but it is the only type which could be cured of portal hypertension.Pancreatic diseases are the chief pathogeny of regional portal hypertension,and the obstruction of spleen vein is the basic reason.The common clinical manifestation is isolatism varicose veins of pylorus.The golden standard of its iconography diagnosis is DSA,and the treatment should follow the individual principle.The splenectomy is the basic measure for them who have UGIB or hypersplenism.This is a review about recent advance in regional portal hypertension of etiology and classification,pathology and physiology,clinical manifestation,diagnosis,radiographic examination,cure,and so on.

The techniques for endoscopic diagnosis and treatment of biliary and pancreatic diseases mainly include endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography,which have achieved great progress in recent years.Meanwhile,new techniques including combined therapy with endoscopy and laparoscopy and natural orifice transluminal endoscopic surgery have gradually been applied in clinical practice.In the future,it is necessary to cultivate interdisciplinary experts in the field of endoscopy who master various endoscopic techniques and integrated talents with experience in both transluminal operation and gastrointestinal surgery outside lumens.At present,there are still controversies over the application of new techniques in the treatment of biliary and pancreatic diseases.The diagnosis and treatment of biliary and pancreatic diseases can be further improved by promoting the application of biliary and pancreatic endoscopy and standardization,accumulating experience and improving devices,evaluating clinical research,and promoting the bench-to-bedside translation of new techniques.

Objective:To discuss the effect of Jianpi Shugan Huoxue Prescription on ICAM-1 gene expression in H22 hepatic cancer mice. Methods: Animal model of H22 hepatic cancer mice were established by inoculating tumor cell. Mice were randomly divided into six groups: the normal group, the model group , Cyclophosphamide group, low, middle and high dosage groups of Jianpi Shugan Huoxue Prescription. The gene expression of ICAM-1 were detected by reverse-transcription polymerase chain reaction (RT-PCR). Results: Compared with model group, the contents of ICAM-1 in serum in the middle and high dosage groups of Jianpi Shugan Huoxue Prescription both decreased(P

Objective Research reconstruction methods of complicated hand injury and transfer types of combined free tissues Methods Applying combined three free tissues to reconstruct extent hand injury 36 cases, there were total four types Results Thirty six cases with 108 free tissues were all survival, the wounds were healed After more than 1 year follow up, restoration of the sensation of pain and temperature were recovered in the transplantation toe and wrap around flap, the two point discrimination was 6～12 mm The function of pinch and opposed was restored The patients can comply the day of life Conclusion Utilization the combined three free tissue transfer to reconstruction complicates hand injuries The time of operation is long, more trauma, reasonable arrange of hand surgeons and have a good knowledge of microsurgery, but the times of operations is less, and shorted the therapy procedure and early rehabilitation