ObjectiveTo investigate the relationship between hepatitis B markers and HBV-DNA content.Methods230 cases with hepatitis were selected.ELISA method was used to detect serum markers,PCR method fordetecting the content of HBV-DNA.ResultsIn 76cases of HBeAg positive specimens,72 cases were HBV-DNA positive,the positive rate was 94.7％ ; in 154 patients with HBeAg negative specimens,72 cases were HBV-DNA posifive,the positive rate was 46.7％.The difference between HBeAg positive group and HBeAg negative group was statistically different( P ＜0.01 ).ConclusionIn patients with chronic hepatitis B,serum markers reflected,HBV can understand the in vivo infection,cannot directly reflect the in vivo replication of HBV.Detection of HBV-DNA content can better reflect the virus replication.

Objective To develop converting rule from international classification of disease (ICD) codes of trauma to abbreviated injury scale (AIS) values so as to provide clues for a simple and convenient trauma scoring way. Methods The corresponding set relations were made for ICD-9CM codes and AIS-90 codes with similar code meanings in the trauma diseases. Based on medical theories and knowledge, 8 indeces closely associated with injury severity were worked out for each ICD-9CM code of trauma diseases by using the database of discharge abstracts of trauma patients. Discriminant analysis was used to set up corresponding relations of ICD-9CM codes with AIS values. Results Seven indices were selected for discriminant function. Corresponding relations of all ICD-9CM codes of trauma diseases with AIS values was made through nonparametric discriminant method. Under deliberation and revision by several clinical experts on traumatology, the converting rule was established eventually. Consistency analysis between the sample's international classification of disease injury severity score (ICISS) values and injury severity score (ISS) values showed that ICISS values were closely correlated with 2-ICISS (Y=Ln), with correlation coefficient of 0.831 1 ( P

Objective To develop a new comprehensive trauma score method based on international classification of diseases(ICD) and evaluate the effectiveness of its use in cerebral injured patients.Methods The model of the new trauma score method was constructed by referring to those of some certain comprehensive trauma score methods generally used around the world.Receiver operating characteristics(ROC) analysis was employed to evaluate the effectiveness of outcome prediction for 355 cerebral injured patients using the new developed trauma score method.Statistical comparisons were performed between the AUC for the new trauma score values and that of NISS values derived from two professional raters.Results The area under the curve(AUC) for the new trauma score values was as large as 0.925 4,whose 95% CI ranged from 0.863 4 to 0.987 5,and is statistically different from 0.5(P

Objective To compare the clinical outcomes of total laparoscopic pancreatoduodenectomy (TLPD) and open pancreaticoduodenectomy (OPD).Methods From August 2013 to December 2014,137 pancreaticoduodenectomies (PDs) were performed at the Department of General Surgery of our hospital,of which 19 TLPDs were performed at the Department of Minimally Invasive Surgery (the Experimental group).At the same time,another cohort of 19 OPDs were matched for age,gender,body mass index (BMI),ASA score and tumor site and they formed the control group.The clinical data in the perioperative period were evaluated,and the short-term clinical outcomes were compared.Results Operation time in the experimental group was significantly longer than the control group [(407.8 ± 146.5)min vs (263.3 ± 65.3) rmin,P ＜ 0.05].The mean intraoperative blood loss [(309.7 ± 151.2)ml vs (509.4 ± 309.9)ml],mean intensive care time after surgery [(47.5 ±16.8)h vs (68.1 ± 19.1)h],mean postoperative time to pass flatus [(3.5 ± 1.1) d vs (4.3 ± 1.1) d],mean postoperative hospitalization stay [(8.8 ± 2.1) d vs (10.8 ± 2.3)d] and mean incision length [(5.1 ± 0.9)cm vs (14.4 ± 1.3)cm] in the experimental group were significantly different from the control group (P ＜ 0.05).There were no significant differences on the intraoperative R0 resection rates,intraoperative pathology,tumor size [(20.6 ± 9.6) mm vs (25.9 ± 10.2)mm],number of lymph node dissected [(17.7 ± 6.5) vs (19.4 ± 5.6)],complication rates,recurrence rates and mortality between the two groups (P ＞ 0.05).Conclusions TLPD had comparable safety and therapeutic outcome when compared with OPD.Moreover,TLPD has the advantages of less bleeding,smaller wounds and faster postoperative recovery.TLPD requires specialized appliances and equipments,better surgeon experience and patient selection to achieve a high success rate.

Objective To assess the leading causes of death and disability adjusted life year (DALY) due to non-communicable disease (NCD) in China.Methods World Health Report 2004 published by the World Health Organization (WHO) was reviewed,including total deaths,deaths per 100 000,agestandardized death rate per 100 000,total DALYs,DALYs per 100 000 and age-standardized DALYs per 100 000 by cause and by member state.Diseases or injuries were assigned to three levels:communicable diseases,NCD and injuries (the first level); categories of disease or injure (the second level); specific diseases (the third level).R2.15 was used for data analysis.Results NCD causes 737.6 million deaths,141million total DALY years,627 age standardized mortality per 100 000,and 10 829 age-standardized DALYs per 100 000.NCD account for 79.4％ and 70.3％ total death or all-cause DALYs.Conclusions Cardiovascular disease,malignant neoplasm and respiratory disease were the leading causes of death,while neuropsychiatric disorder,cardiovascular disease and sense organ disease were the most important causes of DALYs.Among China,the United Kingdom,the United States,Canada,Japan,Korea and India,China ranked second in age-standardized mortality rate of chronic disease.DALYs of esophagus cancer and chronic obstructive pulmonary disease were 6 or 2 times of world average level.Besides,the increasing trend in the prevalence of diabetes mellitus remains impressive.

Objective In order to improve the diagnosis accuracy , 18F-FDG PET/CT results of 169 cases of lung lesions were analyzed. Methods The data of 169 pathological diagnosed patients were collected. SPSS 18.0 was used for the data analysis. Results In 169 cases, 122 cases were proved malignant by patholog-ical diagnosis, in which 110 cases were correctly diagnosed by PET/CT. 47 cases were proved benign by patho-logical diagnosis, in which 15 cases were correctly diagnosed by PET/CT. The sensitivity was 90.2%, specificity was 31.9%, and the accuracy was 74.0%. Conclusion In order to improve the accuracy rate of PET/CT exam-ination and reduce the existence of false positive cases and false positive cases , we should estimate SUV (max) objectively and diagnose according to the size of the lesion , clinical history and laboratory results.

Objective To investigate the factors related to death of thoracic trauma emergency in children.Methods Total 528 children and infants aged 0-14 years with thoracic injuries , including 317 boys and 211 girls, admitted in emergency department from January 2010 to January 2014 were included in the study.The factors related to emergency death were investigated by using conditional logistic analysis.Results Among 528 cases, emergency death occurred in 34 cases with an emergency mortality rate of 6.44%.Single-factor analysis showed that emergency death was correlated with complication with other organ trauma, the time of first medical intervention , the time of arriving at first contact hospital , the rank of first contact hospital , hypoxemia and causes of injuries ( all P<0.05 ); however , not correlated with the gender, age, of patients, areas of residence, family economic status and seasons of injury occurring (all P>0.05).Logistic analysis showed that the time of first medical interventio n>30 min ( B=1.467,95%CI:0.412-0.975), complication with other organ trauma (B=2.342,95%CI:0.415-0.943), hypoxemia (B=2.915,95%CI:0.749-0.819), and first visiting to tertiary hospital (B=-1.861,95%CI:1.023-1.742) were influencing factors of emergency death.Conclusion The results indicate that to improve the success rate of emergency treatment of thoracic trauma in children , it is necessary to reduce the time of first medical intervention and to correct the hypoxemia promptly.

Objective To investigate the expression and significance of myeloperoxidase(MPO) in acute lungs injury of severe acute pancreatitis associated ascetic fluid. Methods Forty-five adult wistar rats were randomly assigned into the group of negative control (group C,n=15),the group of severe acute pancreatitis (group S,n=15) and the group of peritoneal injection (group E,n=15). The group C was cut peritoneum and flipped pancreases softly. In group S,3.5% sodium taurocholate was injected retrograde in pancreatic and bile duct to establish the model of severe acute pancreatitis,and the pancreatic homogenate and ascites of the group S was injected into abdominal cavity of group E rats. After animal model established,rats were killed at 3h,6h and 12h point. The blood of inferior vena cava was sucked for determination of amylase.The inferior lobe of left lung was cut for myeloperoxidase detection.And pathology was regularly done about pancreas and lungs. Results Interstitial edema,hemorrhage and infiltration of neutrophilic granulocyte and macrophage were observed in group S and E. At different time point,the amylase levels of blood and myeloperoxidase of lungs in group S and E were significantly higher than those of group C,and the increasing degree of group E was smaller than group S. Conclusion Acute lung injury can be induced by the severe acute pancreatitis associated ascetic fluid. The expression of myeloperoxidase of lungs was increased to induce acute lungs injury.The reason may be concerned with activation of granulocyte by severe acute pancreatitis associated ascetic fluid.

Objective To investigate the relationship of the serum level of IL-23 and MMP-9 with the clinicopathologic features in patients with esophageal squamous cell carcinoma (ESCC). Methods 48 pathologically confirmed ESCC patients and 30 Endoscopic biopsy of benign were included in this study. The serum levels of IL-23 and MMP-9 were examined by enzyme-linked immunosorbent assay (ELISA). Results Serum IL-23 level in patients with ESCC was significantly higher than that in controls (t = 26.66, 16.89, P<0.05). Furthermore, Pearson′s correlation analysis revealed that serum IL-23 was positively correlated with the serum MMP-9 level in ESCC patients (r = 0.790, P < 0.05). Statistical analysis showed that enhanced serum IL-23 significantly correlated with the degree of differentiation and lymph node metastasis. Conclusion Overexpression of IL-23 may involve in the occurrence and development of ESCC. IL-23 may contribute to tumorinvasion and metastasis by stimulating the expression of MMP-9.

Objective To compare positron emission tomography/computed tomography(PET/CT)vs.endobronchial ultra-sound-guided transbronchial needle aspiration(EBUS-TBNA)in evaluating lymph node metastasis in NSCLC.Methods We col-lected 79 NSCLC patients with enlarged mediastinal lymph nodes(diameter >1 cm by CT).The diagnostic values of PET/CT scanning and EBUS-TBNA for mediastinal staging were evaluated.Subgroup analysis according to histologic type was per-formed.Results There were 22 patients of N1 stage and 28 patients of N2 in these 79 cases.In the N1 patients,PET/CT's sen-sitivity and specificity was 59.1% and 75.4%,respectively.EBUS-TBNA's sensitivity and specificity was 86.4% and 100.0%,respectively.In the N2 patients,PET/CT's sensitivity and specificity was 67.9% and 76.5% and EBUS-TBNA's sensitivity and specificity was 89.3% and 100.0%.Conclusion EBUS-TBNA is more accurate than PET/CT in evaluating the metastatic condition of patients,and EBUS-TBNA can also benefit PET/CT(-)patients with adenocarcinoma.