Objective To investigate the early diagnostic value and cost‐effectiveness analysis of common inflammatory markers , including interleukin‐6 (IL‐6 ) , procalcitonin (PCT ) and C‐reactive protein (CRP) in cirrhotic patients with infectious fever .Methods From January 2012 to January 2015 , cirrhotic patients hospitalized in liver center of First Affiliated Hospital ,Fujian Medical University who were excluded with community‐acquired infections and developed fever 48 hours after admission were selected .According to having infection or not ,they were divided into infection group and non‐infection group .White blood cell count (WBC) ,neutrophil percentage (N % ) ,IL‐6 ,PCT ,and CRP at admission (baseline) and at the time point of fever were recorded .The diagnostic threshold of WBC ,N% ,IL‐6 , PCT ,and CRP for infectious fever in cirrhotic patients were analyzed by receiver operating characteristic analysis curve (ROC) .The cost‐effectiveness (C/E) of those biomarkers were compared .Results A total of 299 cases were enrolled ,with 162 in infection group and 137 in non‐infection group .Two hundred and forty‐four were male and 55 were female .The mean age was 55 .1 ± 13 .0 years .Upon the onset of fever , WBC ,N% ,IL‐6 ,PCT ,and CRP of infection group were all significantly higher than those of non‐infection group (all P< 0 .05) .The area under the curve of IL‐6 for infectious fever was 0 .939 (95% CI 0 .910 - 0 .968) ,which was significantly higher than those of PCT and CRP (Z = 5 .718 and 9 .048 , respectively ,both P< 0 .01) .The optimal cut‐off point of IL‐6 was 184 .5 ng/L ,with the sensitivity of 85 .2% and specificity of 94 .9% .C/E value was 38 .3 for N% ,and 51 .2 for CRP . However ,both specificity and specificity of CRP and N % were low .C/E value was 389 .0 for PCT and 63 .4 for IL‐6 .IL‐6 had the highest sensitivity (85 .2% ) and specificity (94 .9% ) among all the biomarkers .Conclusions Compared to PCT and CRP ,IL‐6 has the highest sensitivity and specificity with lower cost‐effectiveness for diagnosis of infectious fever in cirrhotic patients .

Objective To study the clinical efficacy of lateral collateral ligament reconstruction surgery com-bined with arthroscopy in treatment of chronic lateral ankle instability.Methods 60 cases with chronic lateral ankle instability were selected,the patients were divided into the study group and the control group according to a random number table,which has 30 cases in each group.The control group was received conservative treatment, the study group was underwent exploratory arthroscopic ankle cleanup combined with peroneus brevis tendon lateral ligament reconstruction surgery.Scores before and after treatment of the two groups were detected in American bare foot and ankle surgery-hindfoot score system( AOFAS) .And excellent rate,the recurrence rate and complication rate between the two groups were compared.Results AOFAS score before treatment of the two groups had no significant difference (P>0.05),AOFAS score after treatment of two groups were significantly higher,and that of the study group was sig-nificantly higher than the control group,the difference was statistically significant (t=9.837,10.873,8.789,all P<0.05);Excellent rate of the study group was 96.7% (29/30) significantly higher than the 73.3% (22/30) in the control group,recurrence rate of the study group was 0.0% (0/30),significantly lower than the 13.3% (4/30) in the control group,the complication rate of the study group was 3.3%(1/30),significantly lower than the 20.0%(6/30)in the control group,the difference was statistically significant (χ2 =13.982,15.037,13.298,all P<0.05). Conclusion Lateral collateral ligament reconstruction surgery combined with arthroscopy in treatment of chronic lat-eral ankle instability has better clinical efficacy,the recurrence rate is low,and has less complications.

Manual Muscle Testing is a widely used muscle power testing method in rehabilitation practice. Although it's a key content in rehabilitation medicine and rehabilitation therapy, there are some disagreements in lots of books introducing the development and rating system of it. This article reviewed the development of Manual Muscle Testing and different rating systems.

Breast cancer is the most common malignant tumor in women, bone related events (SREs), such as bone pain, pathological fracture and so on, can affect seriously the quality of life.Experts in Chinese Anti-Cancer Association, Committee of Breast Cancer Society (CACA-CBCS) discussed the Consensus on the Diagnosis and Treatment of Bone Metastasis and Skeletal Related Diseases in Breast Cancer (2014 version), here reflections on several hot issues were explored.

Gastrointestinal neuroendocrine tumor is a group of heterogeneous tumors and was considered as a rare tumor.According to the data of recent years,its incidence has been increased significantly.The clinical manifestations of gastrointestinal neuroendocrine tumors are varied,and serum chromogranin-A is considered the most important biomarker of both non-functioning and functioning neuroendocrine tumors.The traditional imaging examination and somatostatin receptor scintigraphy are helpful to diagnosis.Its treatments include surgery,biological treatment,radionuclide therapy and chemical therapy.The aim of this paper is to summarize briefly the clinical symptoms,diagnostic methods and treatment options of gastrointestinal neuroendocrine tumors.

Objective To explore the basic method and clinical application of spatio-temporal image correlation (STIC) in the routine scanning of normal fetal heart. Methods Totally 120 volume datasets of normal fetal heart were acquired with 2D and STIC, respectively. The difference in time between the two methods were compared and the basic imaging method was explored and analyzed.Results Satisfactory gray-scale volume acquisitions were accomplished in all 120 cases. The quality of the images derived from volume datasets were comparable to that directly obtained from 2D echocardiography. No significant difference of visualization rate was found between the two methods (P>0.05). Some views that could not be showed with 2D were acquired with STIC. In fetal heart screening, STIC (n=104) and routine ultrasonography (n=85) took (4.47±2.32) min and (5.26±2.01) min per case, respectively.Conclusion STIC provides more views and information than 2D, simplifies the picture-gathering process, decreases the dependence of examiner, increases the efficiency, and decreases the exposure upon fetal heart obviously.

Several hot questions such as selection of patients and favorable time of transplantation, design of conditioning regimen, monitoring of chimerism and complication of graft versus host disease (GVHD) in allogeneic hematopoietic stem cell transplantation following reduced intensity regimen (RIC-HSCT) as salvage therapy for refractory leukemia are discussed in this article. More and more investigators began to recognize that it was not a fundamental to undergo transplantation in complete remission for patients with refractory leukemia, since it may expend patients' physical status. RIC-HSCT may be substantially considered as a kind of adoptive immunotherapy, so that immunologic attacking targets and the latency of immunoreactian must be considered when making the decision to use, lacking of attacking targets and rapidly growing diseases seemed to be less susceptible to control. Commonly used reduced intensity regimens differed significantly, but it was clear that dose intensity was very important in refractory leukemia. In fact, many investigators used intermediate dosage between criteria of non-myeloablative and conventional myeloablative regimens. Complete donor chimerism is the hallmark of engraftment but often delayed in RIC-HSCT. Since sustained complete donor chimerism induced persistent graft-versus-leukemia (GVL) effect play an important role in patients' long-term survival, it was recommended that sensitive techniques (eg. STR-PCR) should be used to analysis chimerism and should be measured more frequently (every 2-4 weeks), and lineage-specific chimerism (eg. T cell) analysis was also recommended. As compared with traditional HSCT, the incidences of acute and chronic GVHD are similar and the onset of GVHD is associated with the GVL effect. Decrease or interruption of immunosuppressive drugs early after transplantation and donor lymphocyte infusion may facilitate transformation to complete donor chimerism, so that it may benefit patients with advanced disease at time of transplantation from avoiding disease relapse in one hand, but may induce GVHD in the other hand.

In patients with chronic myeloid leukemia (CML) in chronic phase who have achieved complete molecular remission on imatinib therapy,whether and when to discontinue the drug become a hot topic.The famous clinical trials of discontinue tyrosine kinase inhibitor (TKI) from France and Australia have demonstrated that long-term monotherapy with TKI is not curative in the majority of patients with CML.This has focused attention on strategies to eradicate residual disease in CML patients,which should result in cure and long-term treatment-free remission and leukemia-free survival.This review provides a brife summary of the 55th ASH annual meeting,focusing on the potential combination therapeutics in the era of TKI.

The chemokine CXCL12 and its receptor CXCR4 played a very important role in the gastric carcinoma,which promoted the growth,invasion,and metastasis of the gastric carcinoma through various of signal pathways.In this paper,the literatures related CXCL12,signal pathways and gastric carcinoma were retrieved and explored.And the authors present the research progress concerning the roles of CXCL12 and its regulating mechanism in neoplasm,especially in gastric cancer.

Objective To explore effects of different doses of fluvastatin on serum hs -CRP,NT -proBNP in patients with coronary heart disease (CHD)and chronic heart failure (CHF)and its clinical efficacy.Methods 120 CHD patients with CHF were randomly divided into three groups,each group included 50 cases.Each group received the therapy of 20mg/d(20mg group),40mg/d(40mg group),and 80mg/d(80mg group),respectively,three groups were treated for 12 weeks.The related indicators were compared among the three groups before and after treat-ment,and the incidence of major cardiovascular events (MACE )and adverse reactions were recorded.Results There was no statistically significant difference between groups before treatment (P >0.05).The serum hs -CRP and BNP of three groups were significantly different after treatment(F =185.956,16.824,all P <0.05).The hs -CRP and NT -proBNP of 80mg group were lower than those of group 20mg and 40mg group (hs -CRP:LSD -t value =3.143,4.113,all P <0.05;NT -proBNP:LSD -t value =2.986,3.765,all P <0.05).The △hs -CRP,△NT -proBNP of C group were higher than those of 20mg group and 40mg group(LSD -t value =4.783,5.819,all P <0.05).The TC,TG,LDL -C of three groups were significantly different after treatment (F =14.402,10.929, 121.968,all P <0.05).The TC,TG,LDL -C of 80mg group were lower than those of 20mg group and 40mg group (LSD -t value =3.538,4.765,4.387,all P <0.05).The ALT,CPK of three groups had no significant differences before and after treatment (P >0.05).The incidence of MACE in 80mg group was lower than that in 20mg group and 40mg group.However,the incidence of three groups had no significant difference after treatment (P >0.05 ). Conclusion The treatment of high -dose fluvastatin can significantly decrease inflammatory of CHD patients with CHF,and also decreases the NT -proBNP level,effectively control lipid levels,the treatment is safe and worthy of clinical recommendations.