Objective To evaluate the diagnostic value of combined test of C-reactive protein,amylase and lipase for acute pan-creatitis patients in early stage,and its practicability in assessment of disease severity.Methods 71 cases of acute pancreatitis pa-tients in the hospital from March 2012 to March 2014 were enrolled in the study,including 60 cases of mild pancreatitis patients,11 cases of severe pancreatitis patients.Meanwhile,30 cases of non-acute pancreatitis patients were enrolled as Control Group A,and 50 cases of adults who underwent conventional examination and proved to be healthy were enrolled as Control Group B.Detection of C-reactive protein,amylase and lipase of these samples were performed and the results were recorded,compared and analyzed.Re-sults The serum amylase level of acute pancreatitis patients was (759.42±721.63)U/L,and serum lipase level were (1 624.34± 1 598.25)U/L,which were significantly higher than people in Control Group A and Control Group B,with statistical significance (P <0.05).However,C-reactive protein level of acute pancreatitis patients were (44.61±34.21)mg/L,which were not statistical-ly different compared with Control Group B.Combined test of the three indicators demonstrated that the sensitivity was 95.9%, specificity was 100% and accuracy was 96.9%,all of which were higher than other test combinations or singe test with statistical significance(P <0.05 ).Conclusion The combined test of C-reactive protein,amylase and lipase for acute pancreatitis patients doesn′t only improve early diagnostic efficiency,but also is helpful in disease severity judgment.

Tumor markers play an important role in tumor mass screening, diagnosis and differential diagnosis of tumor, tumor staging, therapeutic evaluation and prognosis assessment. According to the nature,tumor markers can be classified as follows: embryonic antigen, carbohydrate antigens, proteins, enzymes, hormones, and so on. And tumor markers have been used in clinical widely.

Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula ( AVF) and 8 cases of artificial vessel arteriovenous fistula ( AVG).In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension , while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing (χ2 =17.77, P<0.001).All patients underwent percutaneous transluminal angioplasty ( PTA ) . In all patients the vascular diameter was increased significantly after PTA treatment [(3.6 ±0.2) vs.(1.2 ±0.1) mm, t=18.52, P<0.001].The blood flow during hemodialysis was increased significantly after PTA treatment in patients with anastomoti stenosis [(265.4 ±21.5) vs.( 150.5 ±23.1 ) ml/min, t =21.81, P <0.001 ]; however, there were no significant changes in venous pressure [(68.6 ±8.7) vs.(69.3 ±6.1) mmHg(1 mmHg=0.133 kPa), P>0.05].The blood pressure was decreased after PTA treatment [( 71.2 ±7.9 ) vs.( 170.4 ± 15.7) mmHg, t=34.62, P<0.001] in patients with venous outflowtract stenosis , however, there were no significant changes in the blood flow [(264.1 ±15.2) vs.(260.7 ±17.3) ml/min, t=1.04, P>0.05].

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

Objective To investigate the diagnostic value of Lugol solution staining combined with nar-row band imaging (NBI)for esophageal cancer and precancerous lesions.Methods From December 201 3 to December 2014,1 87 patients who were with suspicious esophageal lesions and stained with Lugol solution under endoscopy were selected as control group,while from January 2015 to June 2015,124 patients who were with sus-picious esophageal lesions and examined with Lugol solution staining and NBI under endoscopy were selected as observation group.The sensitivity,specificity and accuracy between the two groups were compared and analyzed. Results One hundred and four cases (75.0%)were found among observation group,which was higher than 93 cases (55.6%)among control group (χ2 =12.07,P <0.01 ).The total detection rates of esophageal cancer and high grade intraepithelial neoplasia (HGN)were 29.0% and 17.7% in observation group respectively,which were higher than 1 8.2% and 6.4% in control group (χ2 =4.15,P =0.04;χ2 =8.54,P <0.01 ).The Kappa value in observation group was 0.55,which was higher than 0.36 in control group.The sensitivity and accuracy in observation group were 89.9% and 82.3% respectively,which were significantly higher than 71 .8% and 68.4% in control group (χ2 =9.79,P <0.01 ;χ2 =7.38,P <0.01 ).Conclusion The sensitivity and accuracy of endoscopic Lugol solution staining combined with NBI for esophageal cancer and precancerous lesions are higher than Lugol solution staining,and it is worthy to popularize the application of Lugol solution staining com-bined with NBI in diagnosing esophageal cancer and precancerous lesions.

BACKGROUND:The chronic wounds, also cal ed non-heading wounds, can seriously affect the quality of life of patients and has brought heavy burden to patients, as wel as health care professionals. celltherapy is a new method for promoting wound healing and plays an important role in the repair of chronic wounds.
OBJECTIVE:To summarize the progress of researches on the chronic wound healing mechanism and celltherapy, and to provide evidences for the clinical management of chronic wounds and relative basic researches.
METHODS:A computer search of CNKI database from 2005 to 2012, PubMed database from 1995 to 2012 and Foreign Medical Journal Ful-Text Service database from 2000 to 2012 was performed using“non-healing wounds, diabetic foot ulcer, wound healing, celltherapy”in Chinese and English as the key words to retrieve articles about chronic wound healing mechanism and the application of celltherapy. Total y, 42 articles meeting the inclusive criteria were included in result analysis.
RESULTS AND CONCLUSION:The wound healing is a complex biological process, involving multiple celltypes, extracellular matrix and cytokine factors. The delayed healing of refractory wound seriously affects the quality of life of patients and has brought heavy economic burden to patients. At present, many methods have been employed to promote wound repair, such as local hyperbaric oxygen therapy, surgical treatment, herbal Chinese medicine, application of various growth factors, celltherapy and gene therapy. celltherapy is noninvasive and those delivered cells can adapt to their environment, are able to release growth factors and cytokines, and more importantly, are able to deliver the growth factors for the wound healing process due to cellsignaling capabilities. Currently, cells used for the treatment of chronic wound cells mainly include bone marrow stem cells, bone marrow-derived mesenchymal stem cells, cord blood stem cells, peripheral blood stem cells, epidermal stem cells, skin-derived progenitor cells, adipose stem cells, fibroblasts and platelets.

Objective To investigate the etiology and provide data for clinical treatment and therapeutic assessment of congenital clubfoot(CCF) via neuroelectrophysiology on motor and sensory nerves and ultrastructure of sural nerve.Methods Totally 248 patients diagnosed with CCF(338 clubfeet) were studied.Motor nerve conduction velocity(MCV),sensory nerve conduction velocity(SCV) and wave amplitude were detected for any changes.An ultra-structural study of sural nerve ramification was also conducted in 36 patients(36 clubfeet) under electron microscope.The correlation between deformity degree,nerve conduction abnormality and therapeutic outcomes was analyzed.Results The motor nerve conduction in 291 clubfeet(86.1%) and the sensory nerve conduction in 252 clubfeet(74.6%) were found with different degrees of abnormalities such as prolonged latency,declined/disappeared wave amplitude,etc.The ultrastructural observation of sural nerve ramification demonstrated abnormalities in all the 36 cases,showing proliferation of myelin sheath in peripheral myelinated nerve fibers,formation of vacuoles,segmental demyelinating lesions and so on.Part of axial cord was squeezed by the proliferated myelin sheath,which resulted in disappearance of axoplasm.The correlation study showed that as deformity became more severe,the nerve conduction abnormality was more evident,requiring more complicated treatments,and the therapeutic outcomes were less satisfactory.Statistical analysis by Mantel-Haenszel method showed that:① the abnormality rate of motor nerve in different types of CCF is signifi-cantly different(?2=32.31,P

Embryonic stem cell possess multi-directional differentiation capacity and can differentiate into all sorts of cells of three germ layers,it has the widely use in the treatment of tissue repair.Recent study shows that,embryonic stem cells can differentiate into cartilage cells in the effect of cytokines,hormones,micro-environment etc.In the is review,the author explore several studies and review the effects of different factors to the differentiation of embryonic stem cell to chondrocyte.

Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis.Methods By summarized current situation and advancement of serum fibrotic markers,ultrasound,CT and MRI in assessing liver fibrosis,we investigated their value and limitations.Results In addition to diagnosis,non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis.For liver fibrosis,however,non-invasive methods can not monitor effectively reaction to therapy and progression.Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis,and reduce the need of liver biopsy.