Objective To evaluate the current situation of autoantibodies detection in China in order to improve the quality of detection. Method Inviting letters to partitcipate this evaluation were sent to all laboratories that detect auto-antibodies. Those responding laboratories were enrolled to this study. The testing items included antinuclear antibody, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondrial antobody and anti-smooth muscle antibody. The distribution of samples and the analysis of results were both double-blinded. Result The correct rate of ANA, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondria antibody and anti-smooth muscle antibody was 85.4%,81.8%,36.9%, 66.7%, and 50% respectively. Conclusion Comparing with the first quality control results, the overall results is this evaluation have been improved, but there is still a longway to go.

BACKGROUND:Extraction of a wel fixed cementless femoral stem or a cemented stem is difficult during revision of total hip arthroplasty. The extended trochanteric osteotomy provides excellent methods, and combining with long-stem cementless prosthesis can better reduce postoperative complications.
OBJECTIVE:To retrospectively analyze the recent clinical curative effect after extended trochanteric osteotomy combined with long-stem cementless prosthesis in hip revision.
METHODA total of 25 patients undergoing hip revision were selected from the Department of Osteoarthrosis, Pingdingshan First People’s Hospital, China from May 2008 to May 2013. Of them, 17 patients were subjected to the extended trochanteric osteotomy combined with single-incision and double-approaches. The femurs were reconstructed with long-stem cementless prosthesis. Al patients were fol owed-up for 12 to 60 months. Pre-operative and post-operative Harris hip scores, the post-operative complications, the bone cutting length, the length of stem in contact with cortical bone, the length of the end of bone cutting to the end of the prosthesis were recorded.
RESULTS AND CONCLUSION:17 patients were fol owed-up. The mean length of bone was 17 cm (15-23 cm). The mean length of stem in contact with cortical bone was 6.4 cm (4-11 cm). The mean length of the end of bone to the end of the prosthesis was 11.5 cm (8-18.5 cm). After fol ow-up, the mean Harris hip scores were improved from (39.0 ± 13.6) scores preoperatively to (75.0 ± 14.9) scores postoperatively (P<0.01). Subsidence occurred in two hips. The cutting sites of 17 cases of extended trochanteric osteotomy were fixed wel . These data suggested that the operation through single-incision and double-approach to the hip, while preserving the attachment of the external rotators and posterior capsule, wil strength rear hip stability and prevent postoperative dislocations. Recent effects were satisfactory, but the long-term outcomes should be further investigated.

Objective To explore the classification of intracranial arachroid cysts(IAC) in CT cisternography(CTC) and its clinicalapplication.Methods 22 cases of IAC diagnosed by plain CT underwent CTC exminaton. IACs were classified into noncommnicatingintracranial arachnoid cyst (NCIAC) and commnicating intracranial arachnoid cyst (CIAC) by wheather or not filled with contrast media in cysts on CTC. NCIAC cases were selected and treated with neuroendoscopic fenestration.Results 15 cases of NCIAC were found by CTC examination. All the NCIAC patients had definite neurologic findings. Postoperatively, all the patients were improved or cured. Follow-upplain CT scan of 9 NCIAC cases showed the cysts were decreased markedly in size, most of the space around the cysts were replaced bynormal cerebral tissue.Conclusion (1)CTC is simple ,safe and specific for making a final diagnosis of IAC. IACs can be classified into CIAC and NCIAC by CTC findings.(2)Neurosurgical indication for IAC is NCIAC patients with symptoms.

Objective To understand the distribution of clinical departments visited by patients with antineutrophil cytoplasmic antibody associated small vessel vasculitis (ANCA-SVV) to improve physicians' awareness and recognition of its clinical manifestations.Methods Literatures of ANCA-SVV published in Chinese during 1991 to 2001 were retrieved from the compact disks of China Biomedical Literatures.Data from retrieval were analyzed by the clinical departments where the authors worked and the number of patients visited there.Patients with ANCA-SVV hospitalized in China Japan Friendship Hospital during 1997 to May 2002 were analyzed based on the departments they visited and the interval between illness onset to diagnosis established.Results Totally,44 papers about ANCA-SVV published in Chinese during the past 10 years,including 24 case reports,8 short articles and 12 original articles,were retrieved.18 of them were reported by nephrologists with 128 cases,11 by rheumatologists with 46 cases,7 by respiratory physicians with 34 cases,and others of case reports.There were 31 patients with ANCA-SVV hospitalized in China Japan Friendship Hospital during the past five years,11 of them stayed at department of nephrology,8 at department of rheumatology,4 at department of respiratory diseases,3 at department of gerontology,and 2 at department of traditional Chinese medicine.Conclusions Patients with ANCA-SVV,a systematic disease involving multiple organs,could visit varied clinical departments of hospital,and majority of them visited the department of nephrology and then the departments of rheumatology,respiratory diseases and gerontology.

AIM:To explore the effect of component II of broccoli polypeptide on the apoptosis in glioma cells . METHODS:Human glioma SHG-44 cells were cultured and divided into control group and 3, 10, 30 and 100 mg/L com-ponent II of broccoli polypeptide groups .Cell viability was detected by MTT assay .The apoptotic rates were examined by Annexin V/PI staining.The morphological changes of the cells were observed under inverted microscope .The protein ex-pression of Bax and Bcl-2 was detected by immunocytochemistry and Western blotting .The protein level of caspase-3 was also examined by Western blotting .RESULTS:Treatment with component II of broccoli polypeptide for 24 h, 48 h or 72 h induced significant inhibition of viability of SHG-44 cells in a time-and dose-dependent manner .The results of Annexin V/PI staining showed that the apoptotic rates were increased in treatment groups in a dose -dependent manner .The density of glioma cells was decreased after treated with increasing concentrations of the drug , and the apoptotic bodies were ob-served under inverted microscope at 72 h.The results of immunocytochemistry and Western blotting showed that the expres-sion of Bax protein was increased but Bcl-2 protein expression was decreased , and the ratio of Bax/Bcl-2 was increased sig-nificantly compared with control group (P<0.05 or P<0.01).The level of caspase-3 protein was increased in 30 and 100 mg/L component II of broccoli polypeptide groups compared with control group (P<0.01).CONCLUSION:The compo-nent II of broccoli polypeptide increases the ratio of Bax /Bcl-2 and activates caspase-3 protein, thus inducing the apoptosis of glioma cells.

Objective To assess the effect of snapshot freeze (SSF) motion correction algorithm on the image quality of coronary CT angiography (CCTA).Methods Thirty-one consecutive patients underwent coronary CTA without heart rate control.All of the CCTA images were reconstructed by the means of both standard (STD) and SSF motion correction.Image quality and interpretability of STD and SSF reconstructions were compared.CCTA images were interpreted with Likert 4-points score system by two experienced radiologists.The image qualities were assessed on per-artery and per-segment level,and interpretability was performed on per-segment,per-artery,and per-patient levels.Comparisons of variables were performed with paired Wilcoxon rank sum test and paired Chi-square test.Results SSF reconstructions showed higher interpretability than STD reconstructions on per-patient [100.0％ (31/31) vs 64.5％ (20/31),x2 =9.09,P =0.002] and per-artery [100.0％ (124/124) v s 83.9％ (104/124),x2 =18.05,P =0.001] and per-segment level [99.0％ (413/417) vs 89.2％ (372/417),x2 =35.56,P =0.001].Image qualities were higher with the use of SSF than STD reconstructions on LAD [3.3 ± 0.7 vs 2.9 ± 1.0,Z =2.70,P=0.007],LCX [3.1 ±0.8 vs 2.5 ± 1.1,Z =3.23,P =0.001] and RCA [3.3 ±0.6 vs 2.1 ±0.9,Z =4.60,P =0.001],but they were similar on LM [3.9 ± 0.4 vs 3.7 ± 0.6,Z =1.89,P =0.059].Image quality was higher with the use of SSF versus STD reconstructions on per-segment [3.5 ± 0.7 vs 3.0 ± 1.0,Z =10.31,P =0.001] level.Conclusions The use of SSF motion correction algorithm improves image quality and interpretability of coronary CTA without heart rate control.

Objective To evaluate the clinical efficacy of interventional techniques in the diagnosis and therapy of Dieulafoy disease. Methods A retrospective study was performed, including 17 patients with massive upper gastrointestinal hemorrhage (patients without peptic ulcer and portal hypertension or diagnosed with Dieulafoy disease by endoscopic examination). All patients had both DSA and interventional embolization treatment, and were followed for 12 months to appraise the clinical effectiveness. Results Sixteen patients were diagnosed as Dieulafoy disease by using DSA. Fifteen of the 16 patients were treated with embolization successfully withoutserious complications. One patient received subtotal gastrectomy because of upper gastrointestinal hemorrhage recurrence. Nine patients with irregular upper abdominal pain and burning sensation had complete remission after symptomatic management. Fifteen patients who had embolization showed no serious complications during the follow-up period of 12 months, there was no hematemesis and melena for the 15 cases with successful embolization. Conclusion The angiography and embolization are safe and efficacious in the diagnosis and therapy of Dieulafoy disease.

Objective Based on the objective test (A type) results of the 2014 comprehensive clinical course graduation test of 3+2 assistant general practitioners training,this article analyzed the differences between different teaching units,so as to provide objective basis for improving the teaching level of each unit.Method We established a database with EXCEL 2000,and put each question's ID and points,and the score of each student into the computer,so we could get the difficulty coefficient,distinction degree and reliability of the test paper,and calculate the difficulty coefficient and difference of each question.Then we analyzed the difficulty coefficient,the difference and the reliability of the 122 students' testing results,and compared the accuracy to the same question of the 6 teaching units.Result The objective test's (A type) difficulty coefficient is 0.77,distinction degree is 0.19,and reliability is 0.99.The highest score of the 122 students is 47 points,and the lowest score is 28 points,the average score is (38.5 ± 3.9) points.In the 50 questions,3 questions' difficulty coefficient is less than 0.4,14 questions' difficulty coefficient is between 0.4-0.7,33 questions' difficulty coefficient is above 0.7,so the difficulty degree of the paper is relatively low.In the 50 questions,23 questions' distinction degree is less than 0.15,17 questions' distinction degree is between 0.15-0.30,10 questions' distinction degree is above 0.30,so the distinction degree of the paper is relatively high.In the 50 questions,20 questions' accuracy appears larger differences between each unit:9 questions' accuracy has decreased significantly among 1-2 units,4 questions' accuracy decreased significantly among 3 units,3 questions' accuracy decreased significantly among 4 units,only 1 unit has high accuracy among 2 questions,and 2 questions' accuracy decreased significantly among all units.These problems are related to the teachers' teaching ability,the difficulty in mastering the key points of the curriculum,the lack of the concept of the general practitioners training.Conclusion The design of the examination paper is basically in line with the study purpose and the objectives of the training course.This examination paper was highly reliable,and suitable for the professional theory and ability test.There are site differences between each unit,which can provide an objective basis for improving the teaching level of different teaching unit,and we will solve the problems in the form of collective preparation next step.

OBJECTIVETo explore the efficacy of hyperthermal lipiodol embolization and thermocoagulation for the treatment of primary hepatocellular carcinoma.

METHODSOne hundred and thirty-one cases were randomized into two groups: the hyperthermal dilute lipiodol embolization group (63 cases) and the chemoembolization group (68 cases). With Seldinger's method, We first placed the catheter to the targeting vessel superselectively and then put the hyperthermal dilute lipiodol (110 degrees C) 10~30ml to the tumor vessels to IV degree for the former group; gave the lipiodol-epirubicin emulsion by the same way to the latter group.

RESULTSThe rate of tumor minification and AFP normalization in the hyperthermal lipiodol embolization group was higher than that in the lipiodol-epirubicin embolization group. The side effects and the liver damage were mild in the former group. The survival time of the patients in the former group was longer than that in the latter group.

CONCLUSIONSEmbolization of the tumor vessels with hyperthermal dilute lipiodol is more thorough due to its better fluidity. The thermocoagulation of the hyperthermal dilute lipiodol becomes stronger for its higher specific heat. It is therefore a good technique for the treatment of primary hepatocellular carcinoma.

Carcinoma, Hepatocellular ; therapy ; Contrast Media ; Electrocoagulation ; Embolization, Therapeutic ; Humans ; Iodized Oil ; Liver Function Tests ; Liver Neoplasms ; therapy ; Treatment Outcome

Objective To investigate the image quality and radiation dose of the wider detector array CT scanner with low dose scanning mode in young children with congenital heart disease.Methods Totally 100 consecutive pediatric patients younger than 3 years with congenital heart disease were enrolled.They were divided into two groups.The low dose group with fifty patients underwent axial CT scanning with ECG gating,and the control group with fifty patients were scanned with volume helical shuttle (VHS) technique.CT number and noise of two groups images at the level of ascending aorta,main pulmonary artery,left ventricle,descending aorta and adjacent muscle were measured,and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated.The double blind method was used to evaluate subjective image quality of the level of intra-cardiac,extra-cardiac and coronary artery.Effective dose was also calculated for both groups.Results No significant difference was found in the CT number,image noise,SNR,and CNR between the two groups in the same anatomic regions (P ＞ 0.05).No significant difference was found in subjective image quality between the two groups for the intra-cardiac and extra-cardiac structure(P ＞0.05).The subjective image quality of coronary artery was significant higher in low dose group than the control group(4.10 ± 0.90 vs.2.88 ± 0.82,Z =-5.818,P ＜ 0.05).Effective dose was (0.57 ± 0.30)mSv in group A and (2.39 ± 1.15)mSv in group B with dose savings of 76％ (t =-11.642,P ＜ 0.05).Conclusions The wider detector array CT scanner with low dose scanning mode can improve image quality with lower radiation dose.