Objective To detect the levels of procalcitonin,blood routine,C-reactive protein of children with bronchopneumonia,to analyze the clinical value combined with the age and to provide the experimental basis for clinical diagnosis and treatment.Methods 100 children with bronchial pneumonia were selected.According to admission number,they were randomly divided into the study group and the control group,50 cases in each group.The control group received routine diagnosis and treatment.The study group was deteced blood calcitonin,blood routine,C-reactive protein level and diagnosed and treated combined with the age.The clinical curative effect,recovery time were observed.The referral rate,children fever,cough,X-ray pulmonary inflammation disappeared time,the average recovery time,and medical expenses were assessed and recorded.Results The cure rate of the study group was 80.0%(40/50),which was higher than 66.6%(33/50) of the control group,the referral rate of the study group was 6.0%(3/50),which was lower than 22.0%(11/50) of the control group,the differences were statistically significant (χ2 =8.61,8.95,all P<0.05).The medical expense of the study group was (3 273.15 ±260.35)yuan,which was lower than (5 426.42 ±238.20)yuan of the control group,the difference was statistically significant (t=11.47,P<0.05).The average recovery time of the fever,cough,X-ray pulmonary inflammation in the study group were (3.29 ± 0.48)d,(5.36 ±0.63) d,(4.17 ±0.57) d,(6.48 ±0.86) d,which were shorter than those of the control group [(4.51 ±0.41)d,(6.70 ±0.52)d,(5.84 ±0.61)d,(7.79 ±0.93)d],the differences were statistically significant (t=8.50,8.69,8.27,9.04,all P<0.05).Conclusion In basic hospitals,detection blood PCT,blood levels of C-reactive protein of children with bronchial pneumonia and combined with the age for diagnosis and treatment, the clinical curative effect is better, the improvement time of the clinical signs or symptoms is shortened, referral rate decreased,medical costs declined.It is worth popularization and application in the basic level hospital.

Objective To observe the efficacy of transjugular interventional therapy for patients with hepatic myelopathy after transjugular intrahepatic portosystemic shunt (TIPS).Methods Sixteen patients with hepatic myelopathy afte TIPS were treated with interventional therapy again.Four patients who were treated with drugs through shunt previously had poor prognosis,then the remaining 12 patients treated with current limited shunt had better prognosis,which were analyzed in this study.Activities of daily living were assessed by Barthel index,limb muscle strength scores were assessed by Lovette scoring system.The changes of liver function and portal vein pressure were analyzed by paired t-test,while other data such as serum ammonia level,Barthel index,Lovette scores before and after transjugular interventional therapy were compared by analysis of variance with repeated measurements.Results All the patients had no complication after operations.The liver function and portal vein pressure of 12 patients had no significan change before and after operation.Blood ammonia value were (77.9 ± 17.9) mmol/L after TIPS,(77.9 ± 14.8),(73.4 ± 21.5),(59.5 ± 14.5),(52.0 ± 16.5) mmol/L 1,3,6,12 months after current limited shunt.Compared with that of preoperation(F =6.45,P ＜0.05),it decreased significantly at the 6th and 12th month.Limb muscle strength scores were 2.1 ± 0.7 before current limited shunt,2.3 ± 0.8,3.1 ± 1.0,3.2 ± 1.1,2.8 ± 0.9 1,3,6,12 months after the operation.Compared with preoperation (F =4.97,P ＜ 0.05),muscle strength grading improved significantly at the 3rd,6th and 12th month.Activities of daily living Barthel index were 42.1 ± 10.5 before current limited shunt,47.1 ± 11.0,45.0 ± 8.8 3,6 months after the operation.Compared with preoperation (F =5.05,P ＜ 0.05),activities of daily living had improvement.There were 3,6,2,1 cases of hepatic encephalopathy of Ⅰ,Ⅱ,Ⅲ,Ⅳ stage after TIPS.Three months after current limited shunt there were 7,3,1,0 cases,while there were 8,1,1,0 cases 6 months after the operation.In other 4 patients treated with drugs,2 patients died of liver failure,one was lost to follow.Conclusions Interventional therapy can relieve symptoms of hepatic myelopathy.The operation is safe,effective,and helpful after TIPS treatment.

Objective To evaluate the methods of diagnosis and treatment of thyroid disease with concomitant focal lymphocytic thyroiditis(FLT), and explore the reasons for its confused with Hashimoto′s disease(HD).Methods During the recent 25 years, 207 patients underwent surgical trearment for pathologically diagnosed HD.Among this group, 143 cases of HD with other concomitant thyroid disease were retrospectively analysed.Results Of the 143 cases, 57 cases were found to have thyroid disease with concomitant FLT, and this was 27.5%(57/207) of the total HD group, or 39.9%(57/143) of the group with thyroid disease and concomitant HD.Intraoperative pathologic section revealed that focal lymphocytic infiltration was positive in 87.7%(50/57) of cases. The postoperative hypothyroidism occurrence rate was 19.3%(11/57), of which, 7 cases(7/57, 12.3%) were subclinical hypothyroidism.Conclusions The character of pathologic changes of thyroid disease with FLT and with HD was different. Intraoperative pathologic section can be helpful in the diagnosis of this condition and can have important significance as a guide to the scope of (surgical) resection of the thyroid gland.

Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Objective To investigate the effects of epidermal growth factor (EGF) on the proliferation , migration and apoptosis of adipose-derived stem cells (ADSCs) in vitro. Methods Starved cell model and FasL-induced apoptosis model were established in serum-free media. The effects of 10 nmol/L and 100 nmol/L of EGF on the proliferation, migration and apoptosis of ADSCs in vitro were observed. The exrpessions of signal pathway proteins like phospholipaseC-γ(PLC-γ) , extracellular regulated kinase (ERK) and AKT were also detected. Results The proliferation, migration and anti-ap-optosis of ADSCs were promoted by 10 nmol/L or 100 nmol/L of EGF, and the expressions of PLC-'y, ERK and AKT were up-regulated. Conclusion EGF can promote the proliferation, migration and an-ti-apoptosis of adipose-derived ADSCs in vitro.

BACKGROUND:Increasing attention has been paid on the role of advanced glycation end products in bone tissue. Glucose metabolic disorder is one of the main reasons for the increase of advanced glycation end products.
OBJECTIVE:To observe the change of advanced glycation end products expressed in type 2 diabetes rats, and to investigate the relationship between impaired fracture healing and change of advanced glycation end products expression in vivo.
METHODS:Thirty Sprague-Dawley rats were randomly and equal y divided into two groups:control group (normal feeding) and experimental group (high fat and sucrosum diet feeding to establish type 2 diabetes model). After diabetes models were established, the model of distraction osteogenesis in the left tibiae of al the rats was produced. Distraction was given 0.3 mm per day and continued for 14 days.
RESULTS AND CONCLUSION:After the traction was complete, cal us formation in distraction gap was obviously reduced in experimental group compared with control group by X-ray examination. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis by histology examination. The enzyme-linked immunosorbent assay results showed that, the level of advanced glycation end products was obviously elevated (P<0.01) while osteocalcin was obviously reduced (P<0.01) in experimental group in comparison with control group. The formation of distraction cal us was impaired in the process of fracture healing and blood of type 2 diabetes rats. The increase of advanced glycation end products may be one of the reasons that cause impaired fracture healing in diabetic rats.

Objective To investigate the feasibility,safety,and short term efficacy of endoscopicultrasound guided radiofrequency ablation (EUS-RFA).Methods Three patients with advanced,inoperable pancreatic carcinoma underwent EUS-RFA.Under the guidance of EUS,a 22 gauge fine needle was punctured into the pancreatic carcinoma,and 1 Fr radiofrequency (RF) catheter was placed into the cancer through this 22 gauge needle.RFA was applied at 10 watts for 2 minutes,and then 15 watts for another 2 minutes.The second needle's tract was selected and punctured about 1 ～ 1.5 cm apart from the first needle tract,and the ablation was repeated.Results The average age of these 3 patients was 63 years old.Two patients were diagnosed to have pancreatic tail cancer and one was pancreatic body cancer,and the mean diameter of the tumor was 3.6 cm.Pre-operative EUS-FNA confirmed the presence of malignant cells.EUS-RFA was performed three times at an interval of 2 weeks in the first patient and one time in the last two patients.The average session of EUS-RFA of each lesion was 3.67 times.After 2 weeks,EUS showed that the diameter of the lesions was reduced by 13.9％ on average.There were vacuolar degenerations of variable sizes in those lesions.The serum level of CA19-9 was averagely decreased by 46.5％.Abdominal pain was not obviously aggravated.There were no episodes of pancreatitis,perforation or bleeding within 48 hours after the procedure.The mean follow-up time was 49 days,and no complications occurred.Conclusions EUS-RFA can reduce the diameter of pancreatic carcinoma and decrease the serum level of CA19-9,and it is feasible and safe.

ObjectiveTo summarize the method and experience of the model of rat heterotopic heart transplantation and to improve the rate of success of the experiment.Methods120 heterotopic heart transplantations were performed by Ono's way,including 60 prepared transplantations and 60 formal transplantations.ResultsRate of success of prepared transplantations was 45％,and formal transplantation was 85％.Mean time of formal operation was (74.3±17.1)min,removal time of the donor heart was (7.9±4.2)min,ischemia time was (29.6±10.3) min and the survival time of allograft was (11.1±5.7)days.5 of the recipients had a long-term survival,and the maximum weight was 740 g.ConclusionsGood surgical technique and rigorous perioperative management is very important in setting up the rat model of heterotopic heart transplantation.

Objective To establish an anatomical classification of chronic portal vein thrombosis (PVT) in order to guide the transjugular intrahepatic portasystemic shunt (TIPS) manipulation, and to analyze the correlation between anatomical classification of PVT and the occurrence of hepatic encephalopathy (HE) after TIPS. Methods During the period from June 2010 to June 2013 at authors’ hospital, TIPS with fluency covered stent was carried out in a total of 73 patients with chronic portal vein thrombosis. Based on the location of portal vein thrombosis, the anatomical classification of portal vein thrombosis (PVT-type) was initially established. The changes in portal vein pressure after TIPS were evaluated. The occurrence of HE at 15 days and at 3 and 6 months after TIPS in patients with different PVT-type was statistically analyzed. As the understanding of 0-phase minimal hepatic encephalopathy (MHE) was deepened, the authors added a subdivision to the 0-phase, including normal cognitive function state and minimal hepatic encephalopathy (MHE) into West - Haven grading to further precisely assess the hepatic encephalopathy. Using paired samples t-test, the changes of portal vein pressure after TIPS were evaluated. The grading of hepatic encephalopathy and the number of occurrence after TIPS were particularly recorded, the results were compared between groups at the same time and between the types at different times. Results The preoperative and postoperative portal vein pressure in type Ⅰ patients receiving TIPS therapy was (42.7 ± 9.6) and (35.0 ± 6.7) cm H2O respectively, the difference was statistically significant (t = 7.61, P <0.01);in typeⅡpatients it was(39.8 ± 5.5) and(31.0 ± 5.7) cm H2O respectively(t=17.2, P<0.01);in type Ⅲpatients it was (43.2 ± 5.8) and (32.4 ± 5.0) cm H2O respectively (t = 25.0, P < 0.01); and in type Ⅳpatients it was (43.0 ± 3.7) and (36.6 ± 6.6) cm H2O respectively (t = 4.26, P <0.01). The occurrence of HE 15 days after TIPS was mainly seen in patients with type Ⅳ , Ⅰ and Ⅲb. Phase Ⅰ hepatic encephalopathy mainly occurred in patients with PVT-type Ⅱa, Ⅲb and type Ⅰ. Phase Ⅱ hepatic encephalopathy occurred mainly in patients with PVT-type Ⅱb, Ⅲb and type Ⅰ. Three months after TIPS, the occurrence of MHE was mainly seen in patients of Ⅲa, Ⅱa and Ⅱc type. Phase Ⅰ hepatic encephalopathy mainly occurred in patients with Ⅲa, Ⅱb and Ⅳ type. Phase Ⅱ hepatic encephalopathy occurred mainly in patients with PVT-typeⅡa,Ⅱb andⅢb. Six months after TIPS, the occurrence of MHE was mainly seen in patients of type Ⅱa, Ⅱc and Ⅲb. Phase Ⅰ hepatic encephalopathy mainly occurred in patients with type Ⅱb, Ⅰ and Ⅲb. Phase Ⅱ hepatic encephalopathy occurred mainly in patients with typeⅡb,Ⅲb andⅠ. The HE condition lasted for longer time in patients withⅡb,Ⅲb andⅠtype. Conclusion The establishment of a rational anatomical classification for chronic portal vein thrombosis can effectively guide the clinical application of TIPS. The occurrence of postoperative hepatic encephalopathy is higher in patients with pure main portal vein thrombosis or superior mesenteric vein thrombosis.

Objective To explore the feasibility of using digital imaging processing (DIP)to extract EUS image parameters for the differential diagnosis of autoimmune pancreatitis (AIP)and chronic pancreati-tis (CP).Methods A total of 81 patients with AIP and 100 patients with CP diagnosed from May 2005 to January 2013 were recruited to this study.A total of 105 parameters of 9 categories were extracted from the region of interest by using computer-based techniques.Then the distance between class algorithm and se-quential forward selection (SFS)algorithm were used for a better combination of features.A support vector machine (SVM)predictive model was built,trained,and validated.Results Overall,25 parameters of 5 categories were selected as a better combination of features when the incidence of accurate category was max (90.08%).A total of 181 sample sets were randomly divided into a training set and a testing set by using two different algorithms and 200 random tests were performed.The average accuracy,sensitivity,specificity, the positive and negative predictive values of AIP based on the half-and-half method were (86.04 ± 3.15)%,(83.66 ±6.57)%,(88.54 ±4.37)%,(85.96 ±4.44)% and (87.12 ±4.39)%,respective-ly.Conclusion Computer-aided diagnosis of EUS images is objective and non-invasive,which can improve the accuracy in differentiating AIP from CP.This technology provides a new valuable diagnostic tool for the clinical determination of AIP.