Objective To evaluate the current situation of autoantibodies detection in China in order to improve the quality of detection. Method Inviting letters to partitcipate this evaluation were sent to all laboratories that detect auto-antibodies. Those responding laboratories were enrolled to this study. The testing items included antinuclear antibody, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondrial antobody and anti-smooth muscle antibody. The distribution of samples and the analysis of results were both double-blinded. Result The correct rate of ANA, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondria antibody and anti-smooth muscle antibody was 85.4%,81.8%,36.9%, 66.7%, and 50% respectively. Conclusion Comparing with the first quality control results, the overall results is this evaluation have been improved, but there is still a longway to go.

BACKGROUND:It is an important and complex issue for the incidence of bacterial infection and complications after transplantation. The monitoring and care after transplantation can improve the success rate of transplantation. OBJECTIVE:To search the database of China National Knowledge Infrastructure, North American Clinical Trial Register and Thomson Reuters Web of Science database, and to perform literature metrological analysis and clinical trials registration project analysis on the published literatures of the monitoring and care after transplantation. METHODS:A total of 138 literatures were searched with the key words of“intensive care, transplantation”in the database of China National Knowledge Infrastructure on the intensive care after transplantation. 23 literatures were used for further analysis by reading titles and abstracts and 115 papers were excluded; the Thomson Reuters Web of Science database was searched with the key words of“intensive care, transplantation”for the literatures on the intensive care after transplantation published from 2008 to 2013;the North American Clinical Trial Register was searched with the key words of“intensive care, transplantation”for the related clinical trials, and a total of 50 registered projects were obtained, only 10 interventional studies. RESUTLS AND CONCLUSION:In recent years, the literatures on the intensive care after transplantation show a gradual increase trend. Compared with international research, fewer researches in this field emerge in China, literature quantity and quality need to be improved. There have been 1 693 papers published in the Thomson Reuters Web of Science database regarding the intensive care after transplantation. United States published the most literatures than other countries, total 532 papers, accounting for the largest proportion, 31.424%of total literatures. Transplantation Proceeding published the most literatures, total 144 papers, accounting for 8.506%of total literatures. There are 50 clinical trial registration projects related to the intensive care after transplantation in the North American Clinical Trial Register, 10 of them were interventional study, accounting for the majority, fol owed by observational study. Diagnostic study had no related registration projects. The surgery of transplantation was complex with trauma. The early monitoring and care post-transplantation are directly related to the success of surgery. Strengthening the monitoring and care of patients’ vital signs, rejection, bacterial infections and other aspects can reduce the complications and improve patients survival rate and quality of life.

Objective To understand the distribution of clinical departments visited by patients with antineutrophil cytoplasmic antibody associated small vessel vasculitis (ANCA-SVV) to improve physicians' awareness and recognition of its clinical manifestations.Methods Literatures of ANCA-SVV published in Chinese during 1991 to 2001 were retrieved from the compact disks of China Biomedical Literatures.Data from retrieval were analyzed by the clinical departments where the authors worked and the number of patients visited there.Patients with ANCA-SVV hospitalized in China Japan Friendship Hospital during 1997 to May 2002 were analyzed based on the departments they visited and the interval between illness onset to diagnosis established.Results Totally,44 papers about ANCA-SVV published in Chinese during the past 10 years,including 24 case reports,8 short articles and 12 original articles,were retrieved.18 of them were reported by nephrologists with 128 cases,11 by rheumatologists with 46 cases,7 by respiratory physicians with 34 cases,and others of case reports.There were 31 patients with ANCA-SVV hospitalized in China Japan Friendship Hospital during the past five years,11 of them stayed at department of nephrology,8 at department of rheumatology,4 at department of respiratory diseases,3 at department of gerontology,and 2 at department of traditional Chinese medicine.Conclusions Patients with ANCA-SVV,a systematic disease involving multiple organs,could visit varied clinical departments of hospital,and majority of them visited the department of nephrology and then the departments of rheumatology,respiratory diseases and gerontology.

Objective To evaluate the efficacy of regional perfusion of chemotherapeutic drug in rectal cancer patients who had undergone total mesorectum excision(TME).Methods The therapeutic effects were retrospectively analyzed of 178 rectal carcinoma patients,who were admitted in the hospital from 1999 to 2006,had undergone TME,and then received chemotherapy through various routes.Among them,a catheter was placed in the left internal iliac vein,and chemotherapeutic drug was administered through it postoperatively in 90 patients.The other 88 cases served as control,and they received systemic intra-venous chemotherapy after TME.No significant difference on clinical parameters was evident between the two groups during the course of treatment.The 1,3 and 5 year local recurrence rates,metastasis rates and survival rates of the two groups were compared.Results The 1,3 and 5 year local recurrence rates in the study group were 0,2.5%(2/79) and 3.9%(3/77),respectively,while they were 1.1%(1/88),3.9%(3/77) and 8.1%(6/74),respectively in control group.There was a significant difference in the local recurrence rate between two groups(P

This study was aimed to investigate the blood-enriching effect of processed Radix Polygoni Multiflori on blood deficiency rats. A total of 140 SD rats were randomly divided into 14 groups, which were the blank control group, blood deficiency model group, positive control group and 11 test groups. The blank control group and model control group were treated with distilled water and the positive control group was given X ue b ao Buxue soluble granules. The test groups were treated with 11 different kinds of processed Radix Polygoni Multiflori sam-ples at a dosage of 2 g?kg-1 respectively. All rats were given drugs once a day. After 10 days, blood samples were collected and the amount of red blood cell (RBC), hemoglobin (Hb), haematocrit (HCT), whole blood viscos-ity and plasma viscosity, prothrombin time were estimated. The results showed that 9 processed Radix Polygoni Multiflori groups can increase the number of RBC and Hb significantly ( P < 0 . 05 or P < 0 . 01 ) in blood deficien-cy rat models. They were the sample processed with decoction of black soybean (DBS) for 24 h, with wine and DBS combination for 24 h , steamed for 4 h and 8 h under high pressure , with DBS for 6 h and 8 h , with wine for 6 h, with wine and DBS combination under high pressure, respectively. The samples processed with DBS un-der high pressure for 8 h increased RBC and Hb were more obviously ( P < 0 . 01 ) . The 8 groups can improve the situation of functional disorder of blood rheology significantly ( P < 0 . 05 or P < 0 . 01 ) . They were the unprocessed samples, processed with DBS and wine for 24 h respectively, with DBS and wine combination for 24 h, steamed for 4 h and 8 h or steamed with DBS for 6 h and 8 h or with wine for 6 h under high pressure respectively. It was concluded that the blood-enriching effect was improved while the R adix Polygoni Multiflori was processed with DBS or wine and under high pressure for 6-8 h .

Objective To evaluate the role of regional chemotherapy via internal iliac artery pump,systemic chemotherapy and total mesorectum excision(TME) in the treatment of rectal cancer.Methods A total of 193 patients with rectal carcinoma divided into 2 groups: The observation group,included 98 cases who underwent TME,regional chemotherapy through internal iliac artery pump and systemic chemotherapy.The other 95 cases,as control group,were treated with systemic chemotherapy after TME.The local recurrence rate,metastasis rate and survival rate were compared between the two groups.Results The local recurrence rate and metastasis rate of the observation group was significantly lower than that of the control group.The local recurrence rate at 1-,3-and 5-year was significantly lower in the observation group[0,2.5%(2/81) and 3.8%(3/79) respectivvely]than that in the control group [1.1%(1/95),11.4%(9/79) and 16.2%(11/68) respectively](P

Objective To explore the affect of acupuncture cooperating with Bobath approach on the spasticity after stroke.Methods 83 patient were divided into treatment group (42 cases) and control group (41 cases). On basis of conventional treatment, the treatment group accepted acupuncture and Bobath approach while the control group accepted a Bobath approach only. They were assessed with Modified Ashworth Scale before and 8 weeks after treatment. Results 8 weeks after treatment, the spasticity reduced in both groups, but more in the treatment group (P<0.05).Conclusion Acupuncture can facilitate the efficacy of Bobath approach on spasticity after stroke.

Objective To investigate the hemodynamic effects of enhanced external counterpulsation(EECP)on cerebral arteries with different stenoses.Methods Zero-dimensional/three-dimensional multiscale hemodynamic models of cerebral arteries with different stenoses were constructed.Numerical simulations of the EECP hemodynamics were performed under different counterpulsation modes to quantify several hemodynamic indicators of the cerebral arteries.Among them,the mean time-averaged wall shear stress(TAWSS)downstream of the stenosis was in the range of 4-7 Pa,a low percentage of TAWSS risk area,and high narrow branch flow were considered to inhibit the development of atherosclerosis and create a good hemodynamic environment.Results For cerebral arteries with 50%,60%,70%,and 80%stenosis,the hemodynamic environment was optimal in counterpulsation mode when the moment of cuff deflation was 0.5,0.6,0.7,and 0.7 s within the cardiac cycle.Conclusions For 50%stenotic cerebral arteries,the counterpulsation mode with a deflation moment of 0.5 s should be selected.For 60%stenotic cerebral arteries,the counterpulsation mode with a deflation moment of 0.6 s should be selected.For 70%or 80%stenotic cerebral arteries,the counterpulsation mode with a deflation moment of 0.7 s should be selected.As stenosis of the cerebral arteries increases,the pressure duration should be prolonged.This study provides a theoretical reference for the EECP treatment strategy for patients with ischemic stroke with different stenoses.

OBJECTIVETo evaluate the role of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and plasma homocysteine levels in Chinese patients with type 2 diabetes mellitus and diabetic retinopathy (DR).

METHODSMTHFR genetic C677T polymorphisms were determined by PCR-restriction fragment length polymorphism. Total plasma homocysteine levels were measured using high-performance liquid chromatography (HPLC) with fluorescence detection.

RESULTSThe frequencies of MTHFR T homogenetic type and CT heterogenetic type and allele T (28.18%, 41.82%, 49.09%) in type 2 diabetic patients with diabetic retinopathy were significantly higher than those in diabetic patients without retinopathy (18.37%,29.59%,33.16%) or the normal controls (17.54%, 28.07%, 31.58%). Howerver, there were no significant differences in the frequency of MTHFR genotype and allele between the type 2 diabetic patients without retinopathy and the normal controls. The presence of T allele appeared to have a strong association with the development of diabetic retinopathy. The odds ratio was 1.94 and the 95% confidence interval was 1.31-2.88. Moreover, the plasma homocysteine levels in patients with TT or CT genotype were markedly higher than those in patients with CC genotype.

CONCLUSIONMTHFR gene C677T mutation associated with a predisposition to increase of plasma homocysteine may represent a genetic risk factor for diabetic retinopathy in Chinese type 2 diabetes mellitus.

Adult ; Alleles ; DNA ; genetics ; metabolism ; Deoxyribonucleases, Type II Site-Specific ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; complications ; genetics ; Diabetic Retinopathy ; blood ; etiology ; genetics ; Female ; Gene Frequency ; Genotype ; Homocysteine ; blood ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; Middle Aged ; Oxidoreductases Acting on CH-NH Group Donors ; genetics ; Point Mutation ; Polymorphism, Genetic

Objective:To investigate the surgical efficacy and prognosis influencing factors of hilar cholangiocarcinoma based on multidisciplinary diagnosis and treatment.Methods:The retrospective cohort study was conducted. The clinicopathological data of 91 patients with hilar cholangiocarcinoma who underwent surgery in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from April 2004 to April 2021 were collected. There were 59 males and 32 females, aged (61±10)years. Patients who were admitted from April 2004 to March 2014 underwent traditional surgical diagnosis and treatment, and patients who were admitted from April 2014 to April 2021 underwent multidisciplinary diagnosis and treatment. Observation indica-tors: (1) surgical situations; (2) postoperative situations; (3) postoperative pathological examina-tions; (4) postoperative prognosis analysis; (5) influencing factors of postoperative prognosis. Follow-up was conducted using telephone interview and outpatient examination. Patients were followed up once every 6 months after surgery to detect survival. The follow-up was up to April 2023. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Comparison of ordinal data was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Kaplan-Meier method was used to draw survival curve and calculate survival rate. The Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard model. Results:(1) Surgical situations. Of the 91 patients, there were 65 cases receiving hemi- or expanded hemi-hepatectomy, 13 cases receiving tri-hepatectomy, 9 cases receiving partial hepatectomy, 4 cases receiving extrahepatic bile duct resection. There were 24 cases receiving combined vein resection and reconstruction, 8 cases receiving combined pancreaticoduodenectomy, 6 cases receiving com-bined hepatic artery resection and reconstruction, including 24 cases receiving extended radical surgery (tri-hepatectomy, hepatic artery resection and reconstruction, hepatopancreaticoduodenec-tomy). The operation time, volume of intraoperative blood loss and intraoperative blood transfusion rate of 91 patients was (590±124)minutes, 800(range, 500?1 200)mL and 75.8%(69/91), respectively. Of the 91 patients, cases receiving extended radical surgery, the volume of intraoperative blood loss were 4, 650(range, 300?1 000)mL in the 31 patients who were admitted from April 2004 to March 2014, versus 20, 875 (range, 500?1 375)mL in the 60 patients who were admitted from April 2014 to April 2021, showing significant differences between them ( χ2=4.39, Z=0.31, P<0.05). (2) Post-operative situations. The postoperative duration of hospital stay and cases with postoperative infectious complications were (27±17)days and 50 in the 91 patients. Cases with abdominal infection, cases with infection of incision, cases with bacteremia and cases with pulmonary infection were 43, 7, 5, 8 in the 91 patients. One patient might have multiple infectious complications. Cases with bile leakage, cases with delayed gastric emptying, cases with chylous leakage, cases with liver failure, cases with pancreatic fistula, cases with intraperitoneal hemorrhage, cases with reoperation, cases dead during the postoperative 90 days were 30, 9, 9, 6, 5, 3, 6, 3 in the 91 patients. Cases with abdominal infection was 10 in the 31 patients who were admitted from April 2004 to March 2014, versus 33 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=4.24, P<0.05). Cases dead during the postoperative 90 days was 3 in the 31 patients who were admitted from April 2004 to March 2014, versus 0 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( P<0.05). (3) Post-operative pathological examinations. Of the 91 patients, cases with Bismuth type as type Ⅰ?Ⅱ, type Ⅲ, type Ⅳ, cases with T staging as Tis stage, T1 stage, T2a?2b stage, T3 stage, T4 stage, cases with N staging as N0 stage, N1 stage, N2 stage, cases with M staging as M0 stage, M1 stage, cases with TNM staging as 0 stage, Ⅰ stage, Ⅱ stage, Ⅲ stage, ⅣA stage, ⅣB stage, cases with R 0 radical resection, cases with R 1 or R 2 resection were 15, 46, 30, 1, 9, 25, 30, 26, 49, 36, 6, 85, 6, 1, 7, 13, 58, 6, 6, 63, 28. Cases with R 0 radical resection, cases with R 1 or R 2 resection were 15, 16 in the 31 patients who were admitted from April 2004 to March 2014, versus 48, 12 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=9.59, P<0.05). (4) Postoperative prognosis analysis. Of the 91 patients, 3 cases who died within 90 days after surgery were excluded, and the 5-year overall survival rate and median overall survival time of the rest of 88 cases were 44.7% and 55 months. The 5-year overall survival rate was 33.5% in the 28 patients who were admitted from April 2004 to March 2014, versus 50.4% in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=5.31, P<0.05). Results of further analysis showed that the corresponding 5-year overall survival rate of cases without lymph node metastasis was 43.8% in the 16 patients who were admitted from April 2004 to March 2014, versus 61.6% in the 31 patients who were admitted from April 2014 to April 2021. There was a significant difference in the 5-year overall survival rate between these patients without lymph node metastasis ( χ2=3.98, P<0.05). The corresponding 5-year overall survival rate of cases with lymph node metastasis was 18.5% in the 12 patients who were admitted from April 2004 to March 2014, versus 37.7% in the 29 patients who were admitted from April 2014 to April 2021. There was no significant difference in the 5-year overall survival rate between these patients with lymph node metastasis ( χ2=2.25, P>0.05). (5) Influencing factors of postoperative prognosis. Results of multivariate analysis showed that poorly differentiated tumor and R 1 or R 2 resection were inde-pendent risk factors influencing prognosis after surgical treatment of hilar cholangiocarcinoma ( hazard ratio=2.62, 2.71, 95% confidence interval as 1.30?5.29, 1.30?5.69, P<0.05). Conclusions:Compared with traditional surgical diagnosis and treatment, treatment of hilar cholangiocarcinoma based on multidisciplinary diagnosis and treatment can expand surgical indications, reduce proportion of dead patients within 90 days after surgery, improve proportation of radical resection and long-term survival rate. Poorly differentiated tumor and R 1 or R 2 resection are independent risk factors influencing prognosis after surgical treatment of hilar cholangiocarcinoma.