Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.

Objective To evaluate Satoh typing for tumor thrombi in the bile duct in patients of hepatocellular carcinoma.Methods A retrospective analysis was made on clinical data of 51 hepatocellular carcinoma patients with tumor thrombi in the bile duct undergoing hepatectomy in Eastern Hepatobiliary Surgery Hospital from Jan 2004 to Dec 2005.The cumulative disease-free survival by the three Satoh types were compared by Kaplain-Meire analysis.and log-rank test.Results There was no operationrelated motality and the postoperative complication rate was 22%(11/5 1).The overall survival rates at 1-and 2-years were respectively 76%(39/51)and 55%(28/51).The overall disease-free survival rates at 1-and 2-years were respectively 53%(27/51)and 22%(11/51).The disease-free survival rates at 1-and 2-years in type Ⅰ patients were respectively 61%(19/31)and 29%(19/31).The disease-free survival rates at 1-and 2-years in type Ⅱ and Ⅲ patients were respectively 35%(7/20)and 10%(2/20).The cumulative disease-free survival rates at 2-years was statistically different between type Ⅰ,type Ⅱ and Ⅲ (v=7.489,P=0.006)).Conclusions Satoh typing of tumor thrombi helps to determine the surgery plan and assess the prognosis of hepatocellular carcinoma with tumor thrombi in the bile duct.

OBJECTIVE:To establish a method for simultaneously determination of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule. METHODS:HPLC was performed on the column of Agilent TC-C18 with mobile phase of methanol-0.2 mol/L ammonium acetate(gradient elution) at a flow rate of 1.0 ml/min;detection wavelength was 250 nm and column temperature was 25 ℃ and injection volume was 10 μl. RESULTS:The linear range was 0.007 1-0.178 0 mg/ml(r=0.999 8)for glycyrrhizin acid and 0.354 8-8.720 0 μg/ml of glycyrrhetinic acid(r=0.999 8);RSDs of precision,stability and reproducibility tests were no more than 1.74%,average recoveries were 95.49%-100.62%(RSD=1.98%,n=9)and 96.80%-102.26%(RSD=1.83%,n=9),respec-tively. CONCLUSIONS:The method is simple,reproducible,accurate and reliable,and can be used for the simultaneous determi-nation of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule.

Purpose To investigate the clinical and pathological features of amyloid nephropathy. Methods A retrospective analysis was conducted in 31 cases of amyloidosis nephropathy. The clinical data and pathologic features of kidney biopsy were analyzed. Re-sults 31 cases of amyloid degeneration accounted for 1. 19% (31/2 603) in all patients of kidney biopsy in the same period. 15 pa-tients were female, and 16 males. Patients’ age ranged from 36 to 77 years old, with mean age of (61. 28 ± 10. 95) years. Clinical staging showed that simple proteinuria were 4 cases (12. 90%), nephrotic syndrome, 21 cases (67. 74%), and renal failure, 6 cases (19. 35%). Under microscope, amyloid deposits were observed in the glomerular mesangial area, capillary basement membrane and small arteries, and those also deposited between renal interstitial and tubular basement membrane in severe cases. Potassium permanga-nate oxidation Congo red staining showed that AL type were 27 cases and AA 4 cases. Immunofluorescence study in some cases showed some degree of weak immunoglobulin and complement deposition, but some cases were negative. Immunohistochemical staining showed different expression of immunoglobulin light chain κ and λ light chains. Under electron microscope, amyloid fibrils were noted in the mesangial area and capillary walls. Conclusion Amyloidosis nephropathy occurs in middle-aged patients with kidney disease, some-times lack of specific clinical manifestations. Renal biopsy is the only approach to confirm the diagnosis. For suspicious patients, renal biopsy should be done as early as possible.

[Objective] To investigate the m vitro effect of asiaticoside on the proliferation of and connective tissue growth factor (CTGF) expression by keloid-derived fibroblasts.[Methods] Tissue samples from patients with keloid were obtained for primary culture of fibroblasts.After 3 to 7 passages,the fibroblasts were incubated with different concentrations (100,10,1,0.1,0.01 mg/L) of asiaticoside or dimethyl sulfoxide (DMSO) for 24,48 and 72 hours followed by the determination of cell viability by methyl thiazolyl tetrazolium (MTT) assay.Immunohistochemistry and Western blot were carried out to quantify the expression of CTGF in the fibroblasts at 48 hours after treatment with different concentrations of asiaticoside.The morphology of fibroblasts was observed before and after the treatment with asiatieoside.[Results] As morphological observation showed,different concentrations of asiaticoside induced an obvious apoptosis and growth inhibition in fibroblasts.The growth of fibroblasts was suppressed by asiaticoside of 1-100 mg/L in a dose-dependent manner (r =0.95,0.90,0.92 for 24-,48- and 72-hour treatment respectively,all P ＜ 0.01 ),and one-factor analysis of variance revealed statistical differences in the growth inhibition rate in fibroblasts between different treatment durations for each tested concentration of asiaticoside (all P ＜ 0.01 ).There was a strong expression of CTGF in untreated fibroblasts,which was weakened by the treatment with asiaticoside for 48 hours.The number of CTGF-positive fibroblasts per 100 cells was 73 in untreated fibroblasts,significantly higher than that in fibroblasts treated with asiaticoside at 1 mg/L (54,t =4.34,P ＜ 0.01 ) and 10 mg/L (46,t =6.26,P ＜ 0.01 ),and statistical differences were observed between the fibroblasts treated with asiaticoside at 1 mg/L and 10 mg/L (t =1.95,P ＜ 0.05).Western blot also showed that the expression of CTGF was inhibited by 48-hour treatment with asiaticoside,and the inhibitive effect displayed a trend to increase with the rise in the concentration of asiaticoside.[Conclusion] Asiaticoside can effectively inhibit the oroliferation of and CTGF expression by fibroblasts in vitro.

Objective To analyse quality assurance(QA) and quality control (QC) during the process of X-ray stereotactic treatment.Methods The dosage of body X-ray irradiation,the treatment room of linear accelevator and the position of targe were measured using the standard inonizing and film dosage methods.Results The maximum error rate of body X-ray irradiation treatment system was 3%,it was in keeping with the national standard level which is 5%.Conclusion It is an essential to establish a comprehensive QA and QC program to guarantee a good treatment precision of X-ray stereotactic irradiation.

Objective To study Curcumine's growth-inhibitory effects and morphological changes on sarcoma grafts of S180 mice,with further inquiry into the possible mechanism.Methods A total of 30 cases of S180 mice were assigned randomly into 3 groups: saline group(blank control),CTX group(positive controlled) and Curcumine group.① The anti-tumor effect on internal organ of mice was observed to study the tumor inhibition rate in different groups.② Influence of curcumine on mice's immune system was studied by comparing the index of thymus and spleen.③ The growth and patho-morphologic changes of tumor cells were observed.④To calculate the index of apoptosis cells and observe the morphological changes of all groups' apoptosis cells under electroscope.Results ① The inhibitory rate was 68.32% in the curcumine group,70.43% in the positive controlled group.Compared to blank control group, these two groups had significantly elevated tumor inhibition rate(P0.05);however,positive thymus index in control group had significant decrease compared with that in the other two groups(P0.05).③ Under electroscope,curcumine group and positive control group had significant decrease in growth of tumor,degree of tumor infiltration,number of nucleus fission,and blood vessel number compared to those in negative control group(P

Objective To summarize the experience on diagnosis and treatment of splenic neoplasm. Methods Clinical data of 40 patients with primary splenic space occupying lesion treated in our hospital were retrospectively analyzed. Results Thirty four out of the 40 cases were diagnosed as primary splenic neoplasm preoperatively. The detectable rate of B-US was 94%, and that of CT was 96%. The discrimination rate of benignancy and malignancy by CT was 84%. Serum AKP and ?-GT were significanfiy increased in most of the malignancies. Seventeen among 22 cases with benignancy were treated by splenectomy, and the others underwent partial splenectomy or tumor resection. Sixteen of 18 patients with malignancy underwent splenectomy, and two did biopsy. Pathology revealed cysts in 13, angiocavernoma in 4, inflammatory pseudotumor in 3, caverous lymphangioma in 1, and cystic degeneration of liomyoma in 1; malignant lymphoma and lymphsarcoma in 9, hemangiosarcoma in 3, and fibrosarcoma, liomyosarcoma, malignant fibrous histiocytoma in 1 each. Three cases with malignancy have survived more than 5 years. Conclusions Splenic neoplasm is diagnosed mainly according to clinical manifestation and image examination. The discrimination of benignancy and malignancy depends on CT, angiography, and serous AKP and ?-GT level. Radical operation and complex treatment could improve the prognosis of splenic malignant tumor.

Objective To evaluate pathogens and antimicrobial resistance of pathogens causing refractory pneumonia in children.Methods Children with refractory pneumonia who admitted to a hospital between May 2008 and December 2014 were performed bronchoscopy,and bronchoalveolar lavage fluid (BALF)were performed bacterial culture and antimicrobial resistance testing.Results 1 693 patients were recruited in the study,273 bacterial isolates were isolated from BALF speci-mens of 226 children,gram-positive bacteria accounted for 38.10% (104/273 ),the main gram-positive bacteria were Streptococcus pneumoniae (n=71)and Staphylococcus aureus (n=23);gram-negative bacteria accounted for 58.24%(159/273),including 44 isolates of Haemophilus parainfluenzae ,28 Klebsiella pneumoniae ,19 Escherichia coli ,and 17 Pseud-omonas aeruginosa ;10 isolates of fungi were also detected,8 of which were Candida albicans .The sensitivity of Streptococ-cus pneumoniae to quinolones,ceftriaxone and cefotaxime were high.Methicillin-resistant Staphylococcus aureus (MRSA) positive rate was 26.32%.ESBLs-producing rate of Haemophilus parainfluenzae and Klebsiella pneumoniae was 32.72% and 62.96% respectively.Conclusion The major pathogens causing refractory pneumonia were Streptococcus pneumoniae and Haemophilus parainfluenzae ,empirical treatment should be conducted accordingly,antimicrobial resist-ance should be considered if therapeutic effect is poor,and targeted therapy should be performed according to cultured re-sults and antimicrobial susceptibility testing result.

Objective To analyze the epidemiological characteristics of mycoplasma pneumoniae (MP) infection among the out-patients and inpatients children in Shenzhen area during 2010-2012 and to explore the significance of the results of the laboratory routine tests in the diagnosis of MP infection .Methods The children patients with respiratory tract infection from 2010 to 2012 were selected and the MP infection and the non-MP infection were screened out .The epidemiological characteristics of gender ,age , etc .,among the children patients with MP infection during these 3 years were analyzed .The differences in the laboratory routine tests and high sensitivity C reactive protein (hsCRP) were compared between the MP infection and the non-MP infection .Results The positive detection rate of MP-DNA in males was slightly higher than that in females ,the difference had no statistical signifi-cance (P>0 .05);MP infection occurred in different age groups ,the positive detection rate of MP-DNA was lowest in the children patients aged <1 year old and highest in the children patients aged 3 - < 6 years (P< 0 .05);the routine laboratory tests and hsCRP level had no specificity in the diagnosis of MP infection .Conclusion The MP molecular epidemiology in Shenzhen area shows that MP infection has the seasonality ,the laboratory routine tests and hsCRP level can not be used as the basis of the MP la-boratory diagnosis .