Objective To study the clinical significance of tumor markers combined assay in the differential diagnosis of pleural effusion.Methods 165 serum and hydrothorax samples were collected from 165 in-patients with pleural effusion.Among them ,55 patients were suffered from malignant pleural effusion and 110 patients with benign pleural effusion.The concentration of CEA,and TSGF were determined by chemiluminescence assay.Results In malignant pleural effusion group,the positive rates of serum CEA and TSGF were 58.8% and 54.3% respectively,the positive rates of hydrothorax CEA and TSGF were 75.8% ,70.7% respectively.Among them,CEA and TSGF in malignant group were significantly higher than that in benign pleural effusion group(P < 0.01 ).So as did of the concentration.The sensitivity of combined assay with serum TSGF in diagnosing malignant pleural effusion was 85.7% ,with the specificity of 97.8%.Conclusion Tumor markers of CEA and TSGF have high clinical values in the differential diagnosis of pleural effusion.The combined assay with TSGF is recommended.

The philosophic mode of bi-cyclic and tri-cyclic mutual crosses have the connotations of the dynamic development and change,reciprocity and transformation,and the unity of opposites.It possesses the peculiarities of the brachylogy and straight view as a method for thinking and studying on the problems of the medicine and other scientific system.It can play an important role in training the students' innovative thinking,their ability to discover and solve problems.

This paper introduces the wavelet transform with multiresolution for liver cancer CT image enhancement. As the wavelet transform with compact support, orthogonality and approximately symmetry, SymletsA (sym4) wavelet family is applied to the two-layer multiscale decompose of the CT image. The decomposed wavelet coefficients are processed with the threshold values of 550, 350 and 250, with the low -frequency region intensified and the high-frequency one weakened. Then the image is reconstructed and thus the image is enhanced. Wavelet transform proves efficient in CT image enhancement.

Objective To study the effects of different nutritional support strategy on acute pancreatitis in rats induced by bile-pancreatic duct ligation. Methods Forty acute pancreatitic rats were divided into four groups and were given simple parenteral nutrition (PN, n=10), early enteral nutrition (EEN,n=10), mid term enteral nutrition(MEN, n=10), and late enteral nutrition (LEN, n=10) respectively. After seven-days of nutritional support, the weight changes and peritoneal dropsy were recorded, the zymologic index of serum biochemistry, pancreatic enzyme level, and malonaldehyde(MDA) concentration were detected, and the pancreatitic tissue were collected, stained with hematoxylin eosin, and histopathologically scored. Results Three rats died in EEN group, and one rat died in MEN group. The weight reduction and peritoneal dropsy in EEN and MEN groups were significantly larger compared with PN and LEN groups(P<0.05). The index of direct bilirubin in EEN rats was significantly higher than that in PN and LEN groups(P<0.05). The index of serum albumin of PN group was higher than those of the other three groups(P<0.05 ) ; the index of hemodiastase of PN group was lower than those of EEN and MEN groups(P<0.05 ) ; the index of hemolipase of PN group was lower than those of the other three groups(P< 0.05). The amount of pancreatic tissue amylase of PN and LEN groups was lower than those of EEN and MEN groups(P<0.05 ) ; the amount of pancreatic tissue lipase of EEN group was higher than those of PN and LEN groups (P<0.05). There was positive relationship between MDA concentration and histopathological score of pancreatic tissue(R=0.93, P<0.05) ; MDA concentration and histopathological score of EEN and MEN groups were significantly higher than those of PN and LEN groups (P<0.05).Conclusion Early enteral nutritional support exacerbates pathological changes of acute pancreatitic rats,which is unfavourable to the recovery of the pancreatitis.

Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

Objective:To evaluate the efficacy and safety of amisulpride and risperidone in the treatment of schizophrenia. Meth-ods:The RCTs literatures on amisulpride and risperidone in the treatment of schizophrenia were retrieved and screened, and the quali-fied ones were analyzed by meta-analysis. Results:A total of 10 literatures were included involving 802 patients. Meta-analysis results showed that the difference between the two groups after the treatment was not statistically significant by comparing the clinical efficien-cy, PANSS score and TESS score. About the incidence of adverse reactions, amisulpride was better than risperidone in the endocrine function, extrapyramidal symptoms, weight gain and cardiovascular system. The incidence of nausea and vomiting of amisulpride was more than that of risperidone. There was no statistical significance in insomnia, headache, dizziness and the others. Conclusion:Ex-isting literature analysis shows that amisulpride is safe and effective in the treatment of schizophrenia.

Objective To assess the efficacy and safety of transurethral bipolar plasmakinetic resection of the prostate(TUPKRP) for the treatment of benign prostatic hyperplasia(BPH).Methods The operation was completed using a bipolar plasmakinetic resection system(CIRCON ACMI).Three trenches were created at 5,7,and 12 o'clock position,respectively,to divide the middle,left,and right lobes of the prostate gland for resection.The bladder neck was widened in overlapping vaporizing swathes to create a wide-necked funnel down to the level of the surgical capsule.The apical tissue was resected to the anterior border of the seminal colliculus.With a F_(20) or F_(22) three-cavity catheter indwelling for 3~5 d,normal saline irrigation was used for 1~2 d postoperatively.Results The duration of the procedure was 20~180 min(53.2?28.7 min),and resected tissue weighed 8~130 g(23.5?21.6 g).The intraoperative blood loss was 10~300 ml(65.4?46.8 ml) and no blood transfusion was required.No perforation of the prostatic capsule or transurethral resection syndrome occurred.The peak urinary flow rate(Qmax) increased from 8.4?1.9 ml/s preoperatively to 18.4?1.8 ml/s 1 month postoperatively(q=55.498,P﹤0.05).The residual urine(RU) decreased from 80.8?59.7 ml preoperatively to 19.5?10.0 ml postoperatively(q=17.287,P﹤0.05). The international prostate symptom score(IPSS) decreased from 25.7?5.5 preoperatively to 5.7?2.4 postoperatively(q=52.969,P﹤0.05).The scores of quality of life(QOL) decreased from 4.4?1.0 preoperatively to 1.1?0.2 postoperatively(q=42.146,P﹤0.05). Conclusions Transurethral bipolar plasmakinetic resection of the prostate for the treatment of benign prostatic hyperplasia is effective and safe,with few complications.

BACKGROUND: Presently used biological factors for inducing bone marrow mesenchymal stem cells (BMSCs) do not obtain mature chondrocytes. Cartilage tissue engineering using BMSCs as seeds does not collect tissue-engineered cartilage, which has value in the clinic. The obtained tissue is cartilage-like tissue. OBJECTIVE: To screen differentially expressed genes between rat BMSCs and chondrocytes by microarray. DESIGN, TIME AND SETTING: The cytology gene study was conducted at the Central Laboratory, First Affiliated Hospital, Dalian Medical University in July 2007. MATERIALS: A total of 8 healthy Sprague Dawley rats aged 2 months were obtained from Animal Experimental Center, Dalian Medical University. 27K Rat Genome Array chip was supplied by Bo’ao, Beijing, China. METHODS: Rat BMSCs and chondrocytes in the aural region were sterilely isolated and cultured in vitro. Total RNA was extracted and purified using Trizol one-step method, and transformed into double chain cDNA probe following reverse transcription. Cy5-dCTP and Cy3-dCTP were used to label BMSCs and chondrocytes, which were hybridized and washed. The fluorescent signals were scanned by a scanner. The values were analyzed and calculated by GenePix Pro 4.0 software. MAIN OUTCOME MEASURES: Gene expression spectrum chip hybridization results. RESULTS: Among the differentially expressed genes (2 times difference), BMSCs as controls, upregulated and downregulated genes were 1 226 and 888, respectively. There were many differential expression gene of BMSCs and chondrocytes. Cy5/Cy3 20 genes are defined as significant differential expression gene. Thus, two important cytokines were found: chondromodulin and connective tissue growth factor. CONCLUSION: The gene chip technique provides an ideal method for screening cytokines during study of tissue-engineered cartilage. Cartilage regulin and connective tissue growth factor highly express in chondrocytes, which indicated that the two have closely association with the differentiation of BMSCs into cartilage.

Electric Stimulation ; Facial Nerve ; physiopathology ; Facial Paralysis ; therapy ; Humans

Objective　To study the similarities and differences on in vitro replication and expression of hepatitis C virus (HCV) between human fetal hepatocytes (HFH) and 7721 cell line. Methods　Human fetal hepatocytes and a hepatoma cell line 7721 were incubated with a serum from hepatitis C patient. After incubation, the presence of HCV RNA, the expression of HCV NS3 antigens in cells and/or supernatant were examined by RT-PCR, in situ hybridization and immunohistochemistry, respectively. Results　It was found that: ①The intracellular HCV RNA was first detected on d 2～3 post-incubation and then could be intermittently detected in cells and/or supernatant subsequently (HCV RNA could be detected in 7721 cells during a period of at least 66 days. In HFH, HCV RNA could be detected up to 25 days after incubation); ②HCV-NS3 antigen could be expressed in infected cells; ③Minus-strand RNA of HCV was mainly located within cytoplasm by in situ hybridization. Conclusion　The results suggest that both the fetal hpatocytes and the hepatoma cell line 7721 are susceptible to HCV, and especially 7721 cell line can stably support HCV replication in vitro and may be used as the target cell for long-term cultures of HCV.