Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

OBJECTIVE:To investigate the characteristics and related factors of drug-induced hyperkalemia,present preven-tive measures and provide reference for the rational drug use. METHODS:46 literatures of individual cases and group cases of drug-induced hyperkalemia publicly reported in domestic medical journals from 1979 to 2014 were collected and analyzed statistical-ly,including 66 cases. RESULTS:66 cases with drug-induced hyperkalemia were mainly involved in cardiovascular drugs and im-munosuppressants. Most of them were improved after drug withdrawal and symptomatic treatment,and 2 cases died. CONCLU-SIONS:Drug-induced hyperkalemia are potentially dangerous. It is necessary to be vigilant,prevent and control timely and reduce the incidence of severe adverse reactions.

Objective To investigate the serum concentration of soluble klotho (s-kl) in systemic lupus erythematosus (SLE) and lupus nephritis (LN) ,and elucidate its role in SLE and LN .Methods A total of 34 patients ,definitely diagnosis as SLE with un-treatment firstly ,were enrolled in this study .The patient were divided into two groups ,those who complicated with LN were assigned to LN group (15 cases) ,the others were distributed to SLE group (19 cases) .At the same time ,17 cases of routine physical examination people were take as control group .24 hours urine of all the cases was collected for examining urinary protein (Upro) .Routine hemocyte analysis ,serum biochemical parameters and ANA and dsDNA were measured by routine method .ELISA was used to detect s-kl ,25-hydroxy vitamin D (25-OH-D) and fibroblast grow th factor-23 (FGF-23) .Systemic lupus erythematosus disease activity index (SLEDAI) was performed in SLE and LN group ,and the creatinine clearance rate(CCr)was calculated accord-ing to the Cockcroft-Gault formula .Pearson′s and linear regression were applied to analyisis the correlation of relevant parameters . Results As compared with the control group ,there were statistically significant differences in mean arterial pressure ,blood rou-tine ,creatine kinase (CK) and lactate dehydrogenase (LDH ) ,complement (C3 and C4 ) and dsDNA in SLE and LN group (P <0 .05) .The level of Upro/24 h ,lipids (CHOL and TG) and creatinine (Scr) in LN group was significantly higher ,while serum al-bumin (ALB) and CCr were obviously lower than those in SLE group and control goup(P< 0 .05) .Difference of s-kl ,25-OH-D and FGF-23 in serum were not observed between SLE and control gropu(P> 0 .05) ,but the serum level of s-kl ,25-OH-D and FGF-23 in LN group were showed a statistical significance when compared with SLE or control group(P< 0 .05) .Meanwhile ,the SLEDAI score was higher in LN than in SLE group(P< 0 .05) .Correlation analysis indicted that s-kl exhibited a positive relationship with 25-OH-D ,C3 and C4 ,while showed a negative correlation with FGF-23 ,SLEDAI and dsDNA(all P< 0 .05) .However ,no any corre-lationt was revealed in regression analysis between the s-kl ,25-OH-D ,FGF-23 and the lupus activity .Conclusion The decrease of s-kl maybe one of the pivotal factors that up-regulated the level of FGF-23 in SLE and LN patients ,thus lead to the deficiency of vi-tamin D and lupus activity .

Objective To investigate the effect of dexmedetomidine postconditioning on acute lung injury (ALI) induced by lipopolysaccharide (LPS) in rats.Methods Fifty male Spragne-Dawley rats,aged 7-8 weeks,weighing 200-250 g,were randomly divided into 5 groups (n =10 each) using a random number table:control group (group C),LPS group and postconditioning with 3 different doses of dexmedetomidine groups (LD,MD and HD groups).ALI was induced with LPS 8 mg/kg injected via the caudal vein in LPS,LD,MD and HD groups.Dexmedetomidine 5,10 and 15 μg/kg were injected intraperitoneally in LD,MD and HD groups,respectively,at 1 h after LPS injection.The equal volume of normal saline was injected intraperitoneally in C and L groups.Blood samples were taken from the left ventricle at 6 h after dexmedetomidine administration,then the animals were sacrificed and broncheoalveolar lavage fluid (BALF) was collected.The concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in plasma and BALF were detected by ELISA.The lungs were removed for microscopic examination of pathological changes and for determination of wet/dry lung weight (W/D) ratio and expression of Toll-like receptor 4 (TLR4) mRNA (by RT-PCR) in lung tissues.Results Compared with group C,W/D ratio,pathological scores,and the concentrations of IL-6 and TNF-α in plasma and BALF were significantly increased,and the expression of TLR4 mRNA was up-regulated in LPS,LD,MD and HD groups.Compared with LPS and LD groups,W/D ratio,pathological scores,and the concentrations of IL-6 and TNF-α in plasma and BALF were significantly decreased,and the expression of TLR4 mRNA was down-regulated in MD and HD groups.There was no significant difference in the parameters mentioned above between LPS and LD groups,and between MD and HD groups.Conclusion Dexmedetomidine postconditioning can alleviate ALI induced by LPS in rats,and up-regulated TLR4 mRNA expression and reduced inflammatory responses may be involved in the mechanism.

Objective To evaluate the correlation between human serum S100A12 level and severity of acute pancreatitis (AP).Methods Serum S100A12 were tested in 64 AP patients in 24 hours after the onset.S 100A12 levels was compared to the severity of AP,and the area under the curve (AUC) of the receiver operating characteristic curve(ROC) of serum S100A12 levels for estimating the severity of AP were made and compared with laboratory parameters and APACHE-Ⅱ,Ranson' s scoring system.Results S100A12 levels in early AP patients were higher than healthy controls (P ＜ 0.05).S100A12 levels increased and correlated with MCTSI scores:patients scored 7-8 ＞ patients scored 4-6 ＞patients scored less than 4 (P ＜ 0.01).S100A 12 levels increased with organ failure (P ＜ 0.01).The AUC of S100A12 in 24 hours after onset for distinguishing MAP between MSAP and SAP was 0.80,cut-off point was 61.83 ng/ml,sensitivity was 70.01％ and the specificity was 73.52％.Serum S100A12 levels were higher in SAP than in MSAP(P =0.01).The AUC of S100A12 in early AP for distinguishing between MSAP and SAP was 0.84,cut-off point was 285.32 ng/ml,the sensitivity was 76.94％ and the specificity was 94.12％,Youden index was 71.00％,positive likelihood ratio was 13.00,negative likelihood ratio was 0.20,the diagnostic performance was better than APACHE-Ⅱ,Ranson and Marshall scoring systems and serum CRP concentration.Conclusions Human serum S100A12 levels elevated at early stage of AP.S100A12 ＞285.32 ng/ml represents high risk of SAP,which is more sensitive and accurate than APACHE-Ⅱ and Marshall scoring system.

Objective To investigate the efficacy of Ganju Bingmei Pill combined with voice therapy in the treatment of vocal nodules .Methods A total of 72 patients with vocal nodules and 60 health people in our hospital were included .Patients were randomly divided into two groups :Group A (36 cases) with Ganju Bingmei Pill thera‐py ,group B (36 cases) with Ganju Bingmei Pill combined with voice therapy .Taking method of Ganju Bingmei Pill was three times a day ,2 tablets every time ,two weeks as one course of treatment with a total of four courses .Voice therapy in Group B was two weeks for one course with a total of four courses .The results were evaluated by voice handicap index ,voice acoustic analysis and laryngostroboscopy .Vocal nodules disappear or significantly reduce indi‐cated that the treatment was effective .Statistical analysis was performed using t - test and chi - square test .Results In group A ,the scores of T ,F ,P ,E were reduced compared with before treatment (P < 0 .05) ,however ,com‐pared with normal control group ,the score of F ,E ,T were still higher than those of normal group (P < 0 .05) .In group B ,the score of T ,F ,P ,E were reduced compared with before treatment (P< 0 .05) ,and compared with normal control group ,the score of F ,P ,E ,T were close to normal(P> 0 .05) .The VHI score in group B were significantly lower than those of in group A (P < 0 .05) .In Group A compared with before treatment ,jitter ,shimmer ,NHR were lower ,F0 was higher(P < 0 .05) ,however ,compared with the group of normal control ,F0 ,jitter ,shimmer , NHR were still statistically significant (P < 0 .05) .In group B with before treatment jitter ,shimmer ,NHR were lower ,F0 was higher (P< 0 .05) ,and jitter ,shimmer were already close to normal(P> 0 .05) .The F0 of group B after treatment was higher than group A ,jitter and shimmer were lower than group A after treatment (P< 0 .05) . After treatment ,there were 28 cases of group A (77 .78% )of patients with vocal nodules disappear or significantly reduce .There were 35 cases of group B(97 .22% ) of patients with vocal nodules disappear or significantly reduce , the effective rate between group A and group B was statistically significant (P< 0 .05) .Conclusion Ganju Bingmei Pill therapy and Ganju Bingmei Pill therapy combined with voice therapy all have curative effect for the treatment of vocal nodules however ,Ganju Bingmei Pill therapy combined with voice therapy is more efficient .

Objective To investigate the effects of apoptosis and related gene p21WAF1 and Bcl-2 in the tumorigenesis of primary gallbladder neoplasms. Methods p21WAF1 and Bcl-2 were detected by immunohistochemistry and apoptotic cells were stained in situ by terminal deoxynucleotidyl transferase mediated-dUTP nick end labeling(TUNAL) in 46 cases of primary gallbladder neoplasms with different histological grades. Results Apoptotic index and p21WAF1 were decreased,but the expression of Bcl-2 was increased with the increasing of the histological grades in primary gallbladder neoplasms (P

Aim To investigate the effect of puerarin on proliferation, differentiation, and mineralization of MC3T3-E1 cells and the expression of TRPM3 mRNA.Methods Proliferation, differentiation, and mineralization of puerarin in MC3T3-E1 cells were determined using CCK-8 assay, alkaline phosphatase(ALP) activity assay, and Alizarin Red Staining, respectively.Effect of puerarin on cell cycle and intracellular calcium concentration of MC3T3-E1 cells was detected by flow cytometry.RT-PCR was used to detect the effect of puerarin on TRPM3 mRNA expression.Resuls 0.1, 1, 10 μmol·L-1 puerarin significantly promoted the proliferation of MC3T3-E1 cells, reduced the proportion of cells in G1 phase, increased the proportion of G2 and S phase, of which 0.1 μmol·L-1 concentration effect was the most significant.Compared with control group, the ALP activity and mineralized nodule area of 0.1 μmol·L-1 puerarin group were significantly increased.The expression of TRPM3 mRNA and the intracellular calcium concentration were significantly decreased in 0.1 μmol·L-1 puerarin group.Conclusion Puerarin can promote the proliferation, differentiation, and mineralization of MC3T3-E1 cells, and reduce the expression level of TRPM3 mRNA and intracellular calcium concentration.

Southern blotting with a labeled and linearized pUC 19 DNA containing a specific fragment of 0. 24 kb DNA of Plasmodium vivax asexual blood stages (kindly offered by Dr. C. Kidson )was used for further identification of blood samples showing positive reaction by dot-blot hybridization. The results showed that those with positive reaction from patients with P. vivax, with P. falciparum or with fever but with negative microscopic findings were also positive by Southern blotting. It was confirmed that some of those positive with P. falciparum were likely to infect P. vivax at the same time. So did a part of those with fever but negative in the blood films (Figs. 1,2).

Objective To investigate the feasibility and safety of primary closure of common bile duct following laparoscopic common bile duct reexploration and choledocholithotomy for recurrent or residual choledocholithiasis in patients with prior biliary surgery.Methods We retrospectively studied the clinical data of 31 patients who were diagnosed recurrent or residual common bile duct (CBD) stones after prior bile duct surgery.All of 31 patients had undergone primary closure following laparoscopic common bile duct reexploration between Jan 2010 and Jan 2014.Results In all the 31 patients,there was no conversion to open surgery.There were no complications due to port placement,postoperative bleeding and mortality.The operation time was (106 ±32) min; the volume of intraoperative blood loss was (52 ± 16) ml; the time of postoperative gastrointestinal function recovery and postoperative hospital stay were (23 ± 3) h,(5.5 ± 1.5) d respectively.Duodenal injury was found and repaired intraoperatively laparoscopically in one patient.Bile leakage occurred in 2 cases recovered by conservative therapy.No postoperative stricture of bile duct,recurrent or residual stones were observed during a period of 1 month to 1 year (mean follow-up 6 months).Conclusions Primary closure following laparoscopic common bile duct reexploration for patients with a past history of biliary tract operation is safe,feasible,and effective procedure in hands of experienced laparoscopic surgeons.