Pulmonary interstitial fibrosis (PIF) is a common complication of connective tissue disease (CTD). The patients with PIF usually manifest with intensive dry cough, progressive dyspnea aggravated by activities, and even weight loss and very fatigued. In this paper, we have applied the traditional methods of "invigorating qi for ascending" and "strengthening earth to generate metal" with modif ied Shenxian decoction for treating CTD combined with PIF to support healthy energy, ascend thoracic qi, and ascend both qi of lung and spleen. We have observed Shenxian decoction could enhance body immune system, benefit the repair of damaged lung tissues, improve microcirculations, and treat both branch and root of body, which has been giving patients prominent effects.

Objective To investigate the degree of cardiac function impairment, and clinical implications of BNP,TnT and TnI in patients with severe sepsis and septic shock retrospectively by comparing the differences in levels of BNP,TnT and TnI among those patients.Methods From December 2005 through December 2010,98 patients admitted with severe sepsis ( n =57 ) or septic shock ( n =41 )were enrolled to be studied.The inclusion criteria were ( 1 ) echocardiography was performed; (2) levels of serum BNP,TnT and TnI were determined on the 1st day,3rd day and 7th days after admission.These 98 patients were divided into 2 major groups:severe sepsis group (S) and septic shock group (SS) ; and each major group was further divided into 4 subgroups,including severe sepsis normal cardiac function (Sn) ;severe sepsis abnormal cardiac function (Sa); severe sepsis death (Sd),severe sepsis survival (Ss);septic shock normal cardiac function ( SSn ),septic shock abnormal cardiac function ( Ssa ),septic shock death (SSd) and septic shock survival (SSs).Then comparisonsof the plasma levels of BNP,TnT and TnI were carried out among groups respectively.The morality difference between groups S vs SS,and Savs Sn,and Ssa vs SSn were compared by using the Chi-square Test.The differences in BNP,TnT and Tnl between groups were compared by SNK-q test.Correlation between ejection fraction (EF) value and those biomarkers was calculated by Pearson correlation coefficient.The relationship between those biomarkers and outcomes was determined by using receiver operating characteristic curve (ROC). Results ( 1 ) There were no significant differences in levels of BNP and TnI between group S and SS,but TnT level in patients of SS group was significantly higher than that in S group ( P =0.001 ).( 2 ) TnT,BNP,Tnl levels in Sa group were significantly higher than those in group Sn; and BNP level in group SSd was significantly higher than that in SSs group (P =0.001 ).(3) BNP,TnT and TnI levels in group Ssa were significantly higher than those in group SSn,and BNP level in SSd group was significantly higher than that in SSs ( Pday 1 =0.001,Pday3 =0.001,Pday7 =0.016). (4) TnT and TnI levels in group SSn were significantly higher than those in group Sn,and BNP levels in SSn group on the 1st day,3rd day and 7th days were significantly higher than those in Sn group (Pday1 =0.006,Pday3 =0.006,Pday7 =0.001).(5) Higher mortality rates in group S and group SS were associated with higher BNP level.(6) Group Sa and Ssa had higher mortality rate than group Sn and SSn ( Sa vs.Sn,P ＜ 0.05,Ssa vs.SSn,P ＜ 0.05).(7) EF and serum BNP level in group Sd and group SSd at admission had negative correlation ( r =- 0.603,P ＜ 0.01 ),and BNP level higher than 0.39 ng/ml within the first 72 hours after admission may be an independent prognostic factor of mortality ( sensitivity 92.9％,specificity 80.8％ ).Conclusions Plasma BNP,TnT,TnI levels have a positive correlation with cardiac function impairment. Significant elevation in BNP,TnT,and TnI levels indicates sever cardiac dysfunction and thus a worsening prognosis is expected.Serum BNP could be a useful diagnostic indicator for the septic patients with cardiac dysfunction.

Mild cognitive impairment is a transitional stage between normal aging and dementia. It is important in terms of recognizing memory loss in older people as well as identifying a group of individuals at high risk of developing dementia and who may benefit from preventive strategies. Ginkgo biloba extract has been shown to possess polyvalent properties, such as anti-oxidation, anti-apoptosis and anti-inflammation. Ginkgo biloba extract appears to have a neuroprotective effect against neurodegenerative diseases.

Objective To explore the association of serum high-sensitivity C reactive protein (hs-CRP) level with leptin in patients with type 2 diabetes mellitns (T2DM). Methods 35 cases of T2DM patients were involved in the study and 16 normal subjects were taken as controls. Fasting serum leptin and CRP were measured .The relationship between them were also analyzed. Results Fasting serum hs-CRP concentration in T2DM group was higher than that in healthy control group, but serum ieptin levels is the same (P > 0.05). Partial correlation analysis demonstrated that fasting hs-CRP level was positively correlated with leptin (r =0.512 ,P =0. 018). Conclusion Fasting serum hs-CRP level is significantly raised in T2DM ,which is associated with leptin. There is chronic inflammatory reaction in T2DM patients,and leptin is possibly involved in inflammatory pathogenesis of T2DM.

Objective To explore the correlation between change of blood lipid and MSCT perfusion imaging in steroid-induced femoral head necrosis in adult rabbits.Methods 20 rabbits 1~1.5 years old in age were divided into two group:16 rabbits in experimental group,8 mg/kg Methylprednisolone was injected twice a week;4 rabbits were used as control group.At 2,4,6,8 week after injection,4 rabbits in experimental group and 1 rabbit in contral group were killed respectively.Before killing the rabbits,the blood lipid was examined and MSCT perfusion imaging was done and the correlation between them was analysed.The index of TRIG,CHOL,Perfusion,PEI,TTP,MTT.All femoral heads were undergone pathological investigation.Results Two weeks after injection,blood lipid began increasing,then blood flow of femoral head decreasing obviously with prolongation of injection;PEI and MTT decrease only 4 weeks after injection.There were a negaitive correlation between blood lipid and blood flow of femoral head.Conclusion There were obviously correlation between the level of increasing blood lipid and blood flow decreasing in steroid-induced avascular necrosis of femoral head in rabbit.

Objective To establish a rapid, accurate and low-cost screening method for the detection of calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN).Methods Seventy cases diagnosed with MPN were collected from 2012 to 2016. PCR combined with high resolution melting (HRM) analysis were used to screen the CALR mutations, and Sanger sequencing and T-A sequencing were applied to verify the HRM positive samples. CALR wild type DNA, type 1 and type 2 mutant DNA samples were selected and analyzed 4 times/day for 5 days to detected the CVs of Tm (melting temperature) respectively. JAK2 mutations were also analyzed in MPN patients to compare the association between JAK2 and CALR mutations.Results PCR-HRM analysis showed 7 cases (26.9%) and 5 cases (20.8%) patients with CALR mutations were screened out from 26 essential thrombocythaemia (ET) cases and 24 primary myelofibrosis (PMF) cases, but no CALR mutations were found in cases with polycythaemia vera (PV). All mutations were confirmed by direct sequencing or cloning sequencing. The CVs for HRM analysis of CALR wild type DNA, type 1 and type 2 mutant DNA samples were 1.91%,1.59% and 1.43%, respectively.There were 47 cases with JAK2 V617F and 1 case with exon12 mutation. No coexistence of JAK2 mutation and CALR mutations were found in a single sample.Conclusion PCR-HRM can be used for rapid screening of CALR mutation. Subsequent sequencing can be applied for rapid diagnosis of MPN patients in clinical practice.

Objective To investigate the relationship between disease activity and osteocalcin,β-isomerized C-terminal telopeptides (β-CTX) in SAPHO syndrome.Methods We studied 58 cases who were diagnosed as SAPHO syndrome.The following indices used to assess the activity of SAPHO were measured:Bath ankylosing spondylitis Disease activity index (BASDAI),Bath ankylosing spondylitis functional index(BASFI),visual analogue scale (VAS) pain and erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),osteocalcin and β-CTX.The SAPHO patients were divided from two groups according to the disease activity.The relationships were analyzed with t-test and Pearson's test.Results The β-CTX of the active group(0.43±0.20) ng/ml was elevated than the stable group (0.23 ±0.09) ng/mL (t=-4.620,P=0.007).And there was no significant difference in the osteocalcin between the active group (2.7±1.0) μg/L and the stable group(2.4±1.0) μg/L (t=-1.169,P=0.820).There was no significant correlation between the serum osteocalcin and ESR or hypersensitive CRP (hs-CRP) (rESR=0.228,PESR=0.088;rhsCRP=-0.085,PhsCRP=0.528).And β-CTX level was related to the VAS (r=0.496,P＜0.01),BASDAI (r=0.401,P=0.002) and BASFI (r=0.295,P=0.025).While no significant relationship between the osteocalcin and pain index was observed in our study.Conclusion The positive correlation between serum β-CTX and disease activity indicates significant bone absorption during the bone destroy process in SAPHO syndrome.

With the combined interruption of the superior mesenteric vein, the splenic artery and vein and the portal vein, we successfully separated the adhesion between the collum pancreatis and the portal vein which is difficult to separate in 8 cases During the separation, the portal vein was damaged in 2～5 parts, and the size of wounds of vein were of 2～6mm in length, but the amount of bleeding was small and the bleeding speed was slow All the wounds were easily repaired under direct vision We consider that the mothod of the combined interruption is safe and effective for the separation of the adhesion between the collum pancreatis and the portal vein, and is helpful to increasing the success rate of removing carcinoma of the head of pancreases The interruption is safe for 20～25 minutes under normothermia

Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of complete vascular ring. Methods Ultrasound images of 6 cases with complete vascular ring were retrospectively analysed and summarized, all cases were confirmed by autopsy after termination of pregnancy. Results Right aortic arch and left ductus arteriosus formed U shaped comlete vascular ring coursing around the trachea in 5 cases, left aortic arch and right aortic arch formed O shaped complete vascular ring in 1 case on three-vessel trachea view. Color Dopple flow imaging aided in identifying various components of the vascular ring. Conclusions Fetal echocardiography is of great clinical value in prenatal diagnosis of complete vascular ring. Three-vessel trachea view is important for screening with particular attention to the relationship of the aortic and duct arches to the trachea.