Objective To investigate the diagnostic significance of combined detection of rheumatoid factor (RF),anti-cyclic cit-rullinated antibody (anti-CCP antibody),glucose-6-phosphatase (GPI)and anti-RA33 antibody in rheumatoid arthritis (RA).Meth-ods One hundred and twenty-six patients with RA,60 patients with other autoimmune diseases and 60 healthy subjects undergoing physical examination were selected as the research subjects.The singled detection of RF,anti-CCP antibody,GPI and anti-RA33 an-tibody,and their combined detection were used to analyze their roles in RA diagnosis.Results Compared with the healthy control group,the four indexes in the RA group were increased,the difference was statistically significant (P<0.05),the RF level in the autoimmune diseases group was increased compared with the control group,the difference was statistically significant(P<0.05). Compared with the the autoimmune diseases group,the four indexes in the RA group were increased,the difference was statistically significant (P<0.05).The sensitivity and specificity of RF to RA were 77.77% and 63.33%;the sensitivity and specificity of anti-CCP antibody to RA were 69.04% and 95.00%;the sensitivity and specificity of GPI antibody to RA were 25.40% and 100.00%;the sensitivity and specificity of anti-RA33 antibody were 27.77% and 99.16%,respectively.The specificity of combined 2 indica-tors was increased from 63.33% to 85.00%,which of combined 3 indicators was increased to 93.33% and which of combined 4 in-dicators even reached to 100.00%.Conclusion The combination of RF,anti-CCP antibody,GPI and anti-RA33 antibody indicators greatly increases with the sensitivity and specificity for diagnosing RA and has clinical significance.

Objective To optimize a preparation technique of Pingfenggujin Granule. Methods The technique was determined by the orthogonal design with content of Astragalosides, polysaccharides and the rate of dried extracts. The contents of polysaccharides and Astragalosides were determined by UV and ELSD-HPLC respectively. Results The optimum water-extraction technique was to steep 2.5 h, ten times of water as much as weigh of total drugs and extract three times, 2 h each. Conclusion The optimum technique is feasible, and the method of content determination is accurate and reliable.

We compared the MGIT 960 method,the reference,and the broth microdilution method for detecting the susceptibility of Mycobacterium tuberculosis isolates to protionamide (PTO).We performed drug susceptibility testing for 248 M.tuberculosis clinical isolates to PTO using MGIT 960 and broth microdilution method.In addition,a total of 117 isolates were randomly selected for further evaluation of the consistency of the minimal inhibitory concentrations determined by these two methods,and eleven concentrations of PTO had been involved accordingly (0.062 5,0.125,0.25,0.5,1,2,4,8,16,32,64 μg/mL).The MGIT method showed an average detection time of 10.1 days,while the detection period of broth microdilution method was 8 days,and the difference was statistically significant (P＜0.001).In addition,the rate of the sensitivity,specificity and concordance between these two methods was 96.5％ (55/57),93.2％ (178/191),and 94.0％ (233/248),respectively.The Kappa value was 0.84.Comparison of the MIC values detected by different methods revealed that the overall concordance rate was 81.2％ (95/117).For the isolates harboring low MIC values (MIC＜8.0 μg/mL),the concordance rate was 86.3％ (82/95),while that of the isolates with high MIC values was only 59.1％ (13/22).In conclusion,our data demonstrate that the broth microdilution method showed excellent concordance with MGIT method for detecting the resistance rate of M.tuberculosis isolates to PTO,indicating that the broth microdilution method with available performance,short turn-around time and convenient manual operation was suitable for rapid detection of M.tuberculosis to PTO.

Objective To investigate the class I integrons and their gene cassettes of imipenem-resistant Pseudomonas aeruginosa (IRPA) , and to analyze the correlation between integrons and drug resistance. Methods PCR was used to determine the presence of integrase genes and class I integrons. The variable regions were detected by sequencing. Resistance genes of integron gene cassettes including metal-β-lactamases, aminoglycoside modifying enzymes (AMEs), 16SrRNA methylating enzyme and the OprD2 genes were detected by PCR. The VITEK-2 automated system was used to determine the antibiotic susceptibility of integron-positive IRPA strains. Results The positive rates of integrase genes and class I integrons were 23.3%(20/86)and 8.14%(7/86) , and five kinds of gene cassettes were detected in 86 IRPA strains. The class I integrons-positive bacterial strains exhibited different resistant patterns to 12 antibiotics with large number of resistance genes. Conclusion The class I integrons and their gene cassettes are associated with multiple drug resistance of IRPA.

0.05)) of antibiotic resistance to ATM,CAZ,FEP,IMP,AMK,and SXT were seen in different types,while remarkable(differences)(P

OBJECTIVE:To establish the method to control the quality of Qilian suppository.METHODS:TLC was per?formed to identify Rhizoma coptidis and Radix Notoginseng.A reverse phase HPLC-ELSD method was adopted to determine the content of ginsenoside Rg 1 and ginsenoside Rb 1 in Radix Notoginseng.RESULTS:The study on the quality control showed that the characteristic of identification by TLC was distinct and highly specific.In this quantification method,the linear ranges of ginsenoside Rg 1 and Rb 1 were1.56?g～3.74?g(r=0.9993,RSD=1.6%)and1.44?g～3.46?g(r=0.9981,RSD=1.2%)respectively.The average recovery rate of ginsenoside Rg 1 was99.10%,and RSD=1.6%(n=3);the average recovery rate of ginsenoside Rb 1 was102.13%,and RSD=1.2%(n=3).CONCLUSION:The method is simple,sensitive,accurate and re?peatable.It can be used for the quality control of Qilian suppository.

Objective To evaluate the safety and therapeutic effect of covered expandable metallic stent placement combined with interventional chemotherapy in treating malignant esophago-tracheal fistulae. Methods A total of 60 patients with esophago-tracheal fistula were enrolled in this study. The patients were randomly divided into control group (n=28) and study group (n=32). Patients of the control group were treated with covered stent implantation only, while patients of the study group were treated with combination use of covered stent implantation and interventional chemotherapy. All the patients were followed up regularly, the short-term and long-term results were determined, and the effect rate, median survival time and complications were statistically analyzed. Results Among the 60 patients, successful obstruction of the fistula was obtained in 58 with a success rate of 96.7%. The median survival time of the 58 patients was 5.8 months. The median survival time of the control group and the study group was 3.6 months and 8.7 months respectively, the difference between the two groups was statistically significant (P<0.05). The one-month, 3-month and 6-month effect rates were 78.1%, 68.8% and 62.5% respectively. The incidence of esophageal stent re-stenosis in the study group was much lower than that in the control group. Conclusion The combination use of covered stent implantation and interventional chemotherapy can effectively improve the median survival time of patients with malignant esophago-tracheal fistula, and reduce the occurrence of stent-related complications. Therefore, covered expandable metallic stent placement combined with interventional chemotherapy is an effective and safe treatment for malignant esophago-tracheal fistulae.

Objective To evaluate the diagnostic role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the smear and culture negative tuberculosis.Methods The tuberculosis suspected patients with spu-tum-negative for three times and with hilar or mediastinal lymphadenopathy were randomly divided into 2 groups,study group received EBUS-TBNA and bronchoalveolar lavage group(BAL) examination,control group received BAL examination only.Chi-square test was used to compare their diagnostic sensitivity and negative predictive value.Results Totally 82 patients were included this study,40 patients were in control group and 42 in the study group.In the control group,tuberculosis was confumed in only 8 cases by means of bacteriological examination in the BAL fluid,27 were confirmed by the following surgery ordiagnostic treatment of anti-Tuberculosis,and the other 5 cases were diagnosis as other diseases; In the study group,tuberculosis was confirmed in 28 patients through bacteriological and pathological examination,8 were false negative and the other 6 were diagnosis as non-tuberculosis diseases.The diagnostic sensitivity in the study group was significantly higher than that in control group (77.8％ verus 22.9％,x2 =21.4,P ＜ 0.01 ) ; and the negative predictive value in the EBUS-TBNA group was also significantly higher than that in the BAL group (42.9％ VS 15.6％,x2 =3.97,P =0.046).Complications were similar inthese 2 groups,only 1 case of intervention required puncture site bleeding happened in the study group.Conclusion EBUSTBNA has a higher sensitivity and negative predictive value in the diagnosis of smear and culture negative pulmorary tuberculosis patients with hilar or mediastinal lymph nodes.This technique is a safe method with few complications than the traditional BAL examination.It may play an important role in the diagnosis of smear and culture negative tuberculosis patients.

AIM: To determine astragaloside Ⅳ in Qixiu Granule (Radix Astragali seu Hedysari, Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, etc.) by HPLC ELSD. METHODS: HPLC ELSD was used in the quantitative analysis by using Alltima C 18 chromatography column and acetonitril water (34∶66) as a mobile phase. The flow rate of mobile phase was 1mL?min -1 . The tube temperature of the detector was 100?C. The flow rate of pure air was 2.7L?min -1 . RESULTS: The regressione quation was Y=-4.40?105+2.07?105X, r=0.9992 (3.73～13.59?g). The average recovery of astragaloside Ⅳ was 100.73%, RSD was 3.97%. CONCLUSION: The method is simple, reliable, accurate and can be regard as the quantity control method of Qixiu Granule.

Objective: To observe the effects of axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata on repairing defects after radical resection of scalp carcinoma in patients. Methods: From February 2006 to December 2015, twenty-one patients with scalp carcinoma were admitted to our hospital, and the carcinoma invaded external lamina or full-thickness of skull and dura mater. After perfect preoperative examination, carcinoma and scalp tissue in 3 to 5 cm from the edge of carcinoma, external lamina or full-thickness of skull and invaded dura mater were resected and sentinel lymph nodes around carcinoma were cleaned in 3 to 4 days after admission. The postoperative defects with size reached from 11 cm×8 cm to 22 cm×18 cm. The flap transplantation was performed at the same time when quick frozen pathological examination results of resected scalp carcinoma margin tissue, skull, dura mater margin and basal tissue, and sentinel lymph nodes showed completely negative. Defects in 3 elderly patients were repaired by single or multiple axial scalp vascular network flaps, with the resected flaps size ranged from 12 cm×7 cm to 19 cm×14 cm. Defects in the other 18 patients were repaired by anterolateral thigh perforator flaps with fascia lata, with the resected flaps size ranged from 13 cm×10 cm to 23 cm×19 cm and the resected fascia lata size ranged from 8 cm×7 cm to 10 cm×10 cm. The head donor site of flap was repaired by medium thickness skin of head and back; the thigh donor site of flap was repaired by medium thickness skin of thigh on the same side. All patients gave up postoperative radiotherapy, chemotherapy, and other follow-up treatments. Results: After operation, the flap and skin in all patients survived completely, with no vascular crisis or other condition. During the follow-up for 6 months to 9 years, all patients showed good appearance except for baldness in operation area of head, with no obvious malformation in head donor site of flap and skin, no swollen external hernia in the brain tissue, and no local recurrence or distant metastasis of carcinoma. The appearance of thigh donor site of flap and skin was good, with normal muscle strength and movement of lower limbs. Conclusions Patients with scalp carcinoma were performed with radical resection of carcinoma, and axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata were applied to repair the postoperative defects, with good appearance of head operation area and no local recurrence or distant metastasis of carcinoma.