Objective To evaluate the role of clinical features,radiography and histopathology in differential diagnosis between chronic necrotizing pulmonary aspergillosis(CNPA)and aspergilloma.Methods Thirty-four patients including 8 cases of CNPA and 26 of aspergilloma comfirmed by operation and histopathology in First Affiliated Hospital,Zhejiang University were investigated retrospectively.The clinical manifestations,radiological and pathological findings of all the patients were analyzed and related references were reviewed. Results The age of onset was not significantly different between CNPA and aspergilloma.Obsolete pulmonary tuberculosis and lung abscess were predisposing factors of them.Productive cough was presented in all 8 cases of CNPA,haemoptvsis in 7,and 5 were presented with constitutional symptoms.The most common symptom of aspergilloma was haemoptysis, which was presented in 25 cases.The less common symptoms were cough and sputum,which was presented in 17 cases.Only two cases were presented with constitutional symptoms."Air crescent"sign at radiography was typical and suggestive of diagnosis in both CNPA and aspergilloma,but the wall of cavity in CNPA was thicker and irregular,infiltrates were often to be seen around the cavity.Histologically,CNPA and aspergilloma both showed septate fungal hyphae branching at an acute angle.CNPA was characterized with the presence of tissue invasion by aspergillus,tissue necrosis and granulomatous inflammation. Fungal hyphae ware only found in a preexistent cavity or ectatic bronchus without tissue invasion in aspergilloma.Conclusions Histopathology is gold standard of differential diagnosis of CNPA and aspergilloma. Meanwhile, clinical features and radiological findings appear to be valuable for the diagnosis.

Objective To investigate the effect of peginterferon alfa-2a injection (PEG-IFNα-2a) combined with ribavirin (RBV) in the treatment of chronic hepatitis C virus (1b) in patients with chronic hepatitis C. Methods The clinical data of patients with type 1b chronic hepatitis C in our hospital from May 2010 to October 2015 were retrospectively analyzed. According to the method of treatment, the patients were divided into IFNα-2a combined with RBV group and PEG-IFNα-2a combined with RBV group. The rapid virologic response (RVR), early virologic response (EVR), and sustained virologic response (SVR) rate were observed in the two groups. The liver function, expressions of CD4+T and CD8+T cell of peripheral blood and the incidence of adverse reaction were compared between the two groups before and after treatment. Results The RVR, EVR, SVR of two groups was no significant difference (χ2=0.641, 0.946, 0.154, P=0.423, 0.331, 0.694). After treatment, the levels of ALT , AST, DBIL and TBIL in PEG-IFNα-2a combined with RBV group were lower than those in IFNα-2a combined with RBV group (P<0.05). Of the PEG-IFNα-2a combined with RBV group, the CD4+T level was lower and the CD8+T level was higher than that in PEG-IFNα-2a in the combined Leigh Bhave Lin group were lower than that in the IFNα-2a level was lower IFNα-2a combined with RBV group(P<0.05). There was no significant difference in the incidence of influenza-like symptoms, marrow suppression, somnolence and abnormal laboratory indexes between two groups. Conclusion PEG-IFN alpha -2a combined with RBV has a good therapeutic effect on type 1b chronic hepatitis C virus, and has good safety and clinical application value.

Forty one patients with esophageal carcinoma (T3N1 M0 or less) underwent video-assisted thoracoscopic surgery (VATS) in prone position for esophagectomy from September 2006 to September 2010.The postoperative outcome and survival of patients were retrospectively analyzed.The results confirmed the feasibility and safety of this minimally invasive esophagectomy performed by thoracoscopy in the prone position for patients with esophageal carcinoma.

Objective To analyze the research status of private hospitals in China for policy recommendations of their development.Methods Using CNKI as the object to retrieve,and key words ofprivate hospital ,social capital to run hospitals or the titles of'private hospitals ,social capital to run hospitals to retrieve 853 articles that are valid and published since end of 2013,for a biliometric analysis.Results The number of articles published were increasing year by year;the most of the articles published in the developed southern areas;the number of articles in hospital internal management was the largest (384 articles,45.02%),followed those on external management and development situation and countermeasures (accounting for 27.43% and 22.39% respectively).Conclusion The increase of articles on private hospitals is connected with the support of national policy,the research of private hospitals is not in balance and its development environment is not favorable.

Thirty-three patients with esophageal carcinoma (T3N1M0 or less) underwent thoracoscopic surgery in lateral prone position for esophagectomy from February 2010 to November 2012.Their postoperative outcomes and survivals were retrospectively analyzed.The results confirmed the feasibility and safety of this mini-invasive thoracoscopic procedure in lateral prone position for patients with esophageal carcinoma.A possible advantage of lateral prone technique is that in case of an emergency switch to open surgery,precious time may be saved in changing body position.

0.05).Conclusions Our results suggest that ascites contributes to the exaggerated fibrinolysis in cirrhosis, whereas cirrhosis self, in the absence of ascites, leads to a slightly fibrinolynic state. The t-PA/PAI imbalance was not a main cause of hyperfibrinolysis in patients with cirrhosis.

This study was aimed to establish a high performance liquid chromatography (HPLC) method coupled with Evaporative Light-scattering Detector (ELSD) in order to develop the determination of fingerprint of terpene lactones in Ginkgo biloba tablets. An Agilent Extend-C18 (4.6 mm í 250 mm, 5 μm) was employed as the analysis column and the normal propyl alcohol-tetrahydrofuran-water (1:15:84) as mobile phase. The column temperature was 30℃. And the flow rate was 1.0 mL·min-1. HPLC coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry (Q-TOF MS) was used to identify the common peaks. The fingerprint was further evaluated by chemometrics methods including principal component analysis (PCA), similarity analysis (SA) and hierarchical clus-tering analysis (HCA). The results showed that the precision, stability and repeatability of this method were favorable. Five common peaks were identified by LC/Q-TOF MS as ginkgolide J ( M ) , C , A , B and bilobalide , respectively . Fourteen batches of Ginkgo biloba tablets were determined. With the aid of PCA, SA and HCA, the common pattern of the fingerprint of terpene lactones was established. Samples were divided into 4 clusters by their quality differ-ence. It was concluded that the method established in this paper can be used for quality evaluation of terpene lac-tones in G ink go b ilob a tablets.

Objective To assess the value of susceptibility-weighted imaging (SWI) in staging hepatic fibrosis (HF) in rabbits. Methods Sixty healthy rabbits were randomly divided into HF group (n=44), control group (n=16). Rabbits in the HF group and supplementary group were injected subcutaneously with 50%CCl4 oily solution to establish hepatic fibrosis model. On the basis of preliminary test, 8 rabbits in the HF group and 4 rabbits in the control group were selected randomly at the 4th, 5th, 6th, 10th week after CCL4 injection ,respectively , to undergo liver MR scan,including conventional axial T1WI, T2WI and axial SWI, DWI scan. All rabbits were sacrificed after MR scan and the tissue of liver were sampled for pathological test and hepatic fibrosis staging. Rabbits were classified into group F0, F1-2 and F3-4 based on pathological results. Liver signal intensity (SI), and liver-to-muscle SI ratio were measured on SWI images and ADC values were measured on DWI images correspondently. One-way ANOVA analysis was performed to compare difference in liver SI, liver-to-muscle SI ratio and ADC values among group F0 (no fibrosis), F1-2 (mild-moderate fibrosis) and F3-4 (severe fibrosis) . Spearman correlation analysis was performed to correlate pathological staging and liver SI, liver-to-muscle SI ratio and ADC values. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of SWI and DWI for staging HF. Results Two and 5 rabbits in the HF group died at the 5th and the 6th week after CCL4 injection , respectively due to acute hepatic necrosis, hepatorrhexis and systemic failure. Seven rabbits in supplementary group were used as supplement. Of the 16 rabbits in the control group, 1 was excluded from the study due to liver fibrosis. Fifteen rabbits in group F0, sixteen rabbits in group F1-2 and sixteen rabbits in group F3-4 underwent MRI and were included into this study. Liver-to-muscle SI ratio in group F0, F1-2 and F3-4 were 0.973 ± 0.020, 0.880 ± 0.090 and 0.649 ± 0.140, respectively. Liver SI were 378 ± 45, 374 ± 19 and 317 ± 34. ADC values were (1.473 ± 0.320) × 10-3, (1.311 ± 0.310) × 10-3 and (0.942 ± 0.180) × 10-3mm2/s. There were statistically significant differences in liver SI, liver-to-muscle SI ratio and ADC values among group F0, F1-2 and F3-4 (F=46.571,15.803 and 15.317, P< 0.01). Liver-to-muscle SI ratio was highly negatively correlated with HF staging (r=-0.818,P<0.01), while liver SI and ADC values were moderately correlated with HF staging (r=-0.565,-0.630;P<0.01). Area under ROC curve (AUC) of liver-to-muscle SI ratio, liver SI and ADC value for differentiating hepatic fibrosis stage F0 and stage F1-4 were 0.916, 0.695 and 0.768, while the AUC for differentiating hepatic fibrosis stage F0-2 and stage F3-4 were 0.951, 0.904 and 0.900. Conclusion Liver-to-muscle SI ratio on SWI provide added diagnostic value and could be an useful parameter for staging hepatic fibrosis.

In this study, 17 kinds of Dendrobium species of Fengdous including 39 individuals were collected from 4 provinces. Mitochondrial gene sequences co I, nad 5, nad 1-intron 2 and chloroplast gene sequences rbcL, matK amd psbA-trnH were amplified from these materials, as well as nrDNA ITS. Furthermore, suitable sequences for identification of Dendrobium species of Fengdous were screened by K-2-P and P-distance. The results showed that during the mentioned 7 sequences, nrDNA ITS, nad 1-intron 2 and psbA-trnH which had a high degree of variability could be used to identify Dendrobium species of Fengdous. However, single fragment could not be used to distinguish D. moniliforme and D. huoshanense. Moreover, compared to other combined fragments, new type combined fragments nrDNA ITS+nad 1-intron 2 was more effective in identifying the original plants of Dendrobium species and could be used to identify D. huoshanense and D. moniliforme. Besides, according to the UPGMA tree constructed with nrDNA ITS+nad 1-intron 2, 3 inspected Dendrobium plants were identified as D. huoshanense, D. moniliforme and D. officinale, respectively. This study identified Dendrobium species of Fengdous by combined fragments nrDNA ITS+nad 1-intron 2 for the first time, which provided a more effective basis for identification of Dendrobium species. And this study will be helpful for regulating the market of Fengdous.

In order to make a report on 90 cases of insomnia treated by the Wei-defensive qi-regulating and brain-strengthening needling technique,as a clinical subject of the multiple center,for assessing the preliminary standardized indications and operating methods and making an initial summary for writing the draft of the technique operation.Methods:By ratio of 1:1,the patients in conformity with the criteria were randomly divided into the experimental group and control group.In the experimental group,45 cases were treated with the Wei-defensive qi-regulating and brain-strengthening needling technique on Baihui (GV 20),Dazhui(GV 14),Shenmai(BL 62),Zhaohai(KI 6),plus ear points.In the control group,45 cases were treated with routine acupuncture on Sishencong(Ex-HN 1),Shenmen (HT 7),Sanyinjiao(SP 6),etc.The therapeutic effects in the two groups were observed and assessed in comparison.Results:The results showed cure in 15 cases.remarkable effect in 27 cases,effect in 42 cases,failure in 6 cases,and the total eriective rate in 94.4% in 90 cases of insomnia.In the three centers,the statistic management was performed based upon PSQI integral and showed significant difference(P＜0.01),and no significant difference among various groups(P＞0.01).Conclusion:The therapeutic effect in the treatment of insomnia by Wei-defensive qi-regulating and brain-strengthening needling technique is better than the control group and the therapeutic effect and methods in various centers are stable.without any deviation.